AV-S Ventilator

Remote Display Module and Interface

for use with A200SP Absorber
Service Manual

Partnership for Life

THE IMPORTANCE OF PATIENT MONITORING
WARNING
Anaesthetic systems have the capability
to deliver mixtures of gases and vapours
to the patient which could cause injury or
death unless controlled by a qualified
anaesthetist.
There can be considerable variation in
the effect of anaesthetic drugs on
individual patients so that the setting and
observation of control levels on the
anaesthesia systems does not in itself
ensure total patient safety.
Anaesthesia system monitors and patient
monitors are very desirable aids for the
anaesthetist but are not true clinical
monitors as the condition of the patient is
also dependent on his respiration and the
functioning of his cardio-vascular system.
IT IS ESSENTIAL THAT THESE ELEMENTS
ARE MONITORED FREQUENTLY AND
REGULARLY AND THAT ANY
OBSERVATIONS ARE GIVEN
PRECEDENCE OVER MACHINE CONTROL
PARAMETERS IN JUDGING THE STATE OF
A CLINICAL PROCEDURE.
IMPORTANT

Servicing and Repairs

In order to ensure the full operational life of this

ventilator, servicing by a Penlon-trained
engineer should be undertaken periodically.

The ventilator must be serviced to the following

schedule:
(a) Six monthly service - inspection and
function testing.
(b) Annual / two year / four year services -
inspection and function testing, and
component replacement.

Details of these operations are given in this

Manual for the AV-S, available only for Penlon
trained engineers.

For any enquiry regarding the servicing or

repair of this product, contact the nearest
accredited Penlon agent:

or communicate directly with:

Technical Support
Penlon Limited
Abingdon Science Park
Barton Lane
Abingdon
OX14 3PH
UK

Tel: 44 (0) 1235 547076

Fax: 44 (0) 1235 547062
E-mail: technicalsupport@penlon.co.uk

Always give as much of the following

information as possible:

1. Type of equipment
2. Product name
3. Serial number
4. Approximate date of purchase
5. Apparent fault

(i)
FOREWORD

This manual has been produced to provide

authorised personnel with information on the
function, routine performance, service and
maintenance applicable to the AV-S
Anaesthesia Ventilator.

Information contained in this manual is correct

at the date of publication.
The policy of Penlon Limited is one of continued
improvement to its products.
Because of this policy, Penlon Limited reserves
the right to make any changes which may affect
instructions in this manual, without giving prior
notice.

Personnel must make themselves familiar with

the contents of this manual and the machines
function before servicing the apparatus.

Copyright Penlon Limited, 2008.

All rights reserved.

(ii)
CONTENTS
Page No.
USER RESPONSIBILITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1. WARNINGS AND CAUTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2. PURPOSE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

3. DESCRIPTION
3.1 General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
3.2 Ventilation Cycle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

3.3 Pneumatic System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

3.3.1 System Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3.4 Electrical System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

3.5 Control Panel ............................................. 15

3.5.1 Touchscreen Operation and Navigator wheel / push-button ............ 15
3.5.2 User Adjustable Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
3.5.3 Operational capability ........................................ 17
3.5.4 Output Compensation Functions ............................... 18
3.6 Interface with Prima SP and A200SP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

3.7 Ventilation Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

3.7.1 Standby Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
3.7.2 Volume Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
3.7.3 Pressure Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
3.7.4 Spontaneous Mode ......................................... 23
3.7.5 Advanced Spontaneous Breathing Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
3.7.5.1 SIMV (Synchronised Intermittent Mandatory Ventilation) . . . . . . . . . . . . . 24
3.7.5.2 SMMV (Synchronised Mandatory Minute Ventilation) ............ 25
3.7.5.3 PSV (Pressure Supported Ventilation) ...................... 26
3.7.5.4 PEEP ( Positive End Expiratory Pressure) . . . . . . . . . . . . . . . . . . . . . . 27

3.8 On-screen Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

3.9 Spirometry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
3.10 Display Waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
3.11 Alarms ...... .............................................. 30

3.12 Oxygen Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

3.13.1 System Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
3.12.2 The MOX-3 Oxygen Sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
3.12.3 Menus .................................................. 32
3.12.4 Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3.12.5 Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3.12.6 Alarm Mute. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

4. SPECIFICATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Ventilator .................................................. 34
Oxygen Monitor . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

(iii)
CONTENTS

5. PRE-OPERATION PROCEDURES
5.1 Ventilator Set-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
5.1.1 Mounting the Ventilator ....................................... 39
5.1.2 Electrical Power Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
5.1.3 Ventilator Gas Supply .................................. 39
5.1.4 Breathing System Schematic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
5.1.5 Bellows Drive Gas ........................................... 43
5.1.6 Anaesthetic Gas Scavenging System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
5.1.7 Remote Screen ........................................... 43
5.1.8 Printer .................................................... 43
5.1.9 Breathing System ........................................... 44
5.1.10 Spirometer Connections ....................................... 44
5.1.11 Pressure Monitor Connections .................................. 46
5.1.12 Bellows Assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

5.2 Pre-use Checklists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

5.2.1 Daily Checklist ........................................... 48
5.2.2 Function Test .............................................. 49
5.2.3 Weekly Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

5.3 Oxygen Monitor Set-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

5.3.1 Installation . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
5.3.2 Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
5.3.3 Sensor Low Indication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
5.3.4 Setting the High and Low O2 Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

6. SERVICE PROCEDURES
6.1 Service Intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
6.2 Control Unit Patient Block Removal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
6.3 Valve Calibration ........................................... 56

7. SERVICE SCHEDULE
Service Schedule ..................................... 57

8. PARTS LISTS
Preventive Maintenance Kits .............................. 66
Assemblies ...................................... .... 67

9. APPENDIX
1. Back-up Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
2. Menu System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
3. Ventilator Spirometry System .......................... .... 82
4. Cleaning / Sterilisation / Oxygen sensor replacement . . . . . . . . . . . . . . . . . 85
5. Software Upgrade Installation Procedure . . . . . . . . . . . . . . . . . . . . . . . . . 89
6. Calibration and Output Checks for a New Ventilator . . . . . . . . . . . . . . . . . . . 90
7. Menu structure amendments (v1.86.01 / .02 / .04) . . . . . . . . . . . . . . . . . . . . 94

(iv)
USER RESPONSIBILITY

This anaesthesia ventilator has been built to Statements in this manual preceded by the
conform with the specification and operating following words are of special significance:
procedures stated in this manual and/or
accompanying labels and notices when WARNING means there is a
checked, assembled, operated, maintained possibility of injury to the
and serviced in accordance with these user or others.
instructions.
CAUTION means there is a possibility
To ensure the safety of this device it must be of damage to the apparatus
checked and serviced to at least the or other property.
minimum standards laid out in this manual.
A defective, or suspected defective, product NOTE indicates points of
must not under any circumstances be used. particular interest for more
efficient and convenient
The user must accept responsibility for any
operation.
malfunction which results from non-
compliance with the servicing requirements
detailed in this manual. Always take particular notice of the
warnings, cautions and notes provided
Additionally, the user must accept throughout this manual.
responsibility for any malfunction which may
result from misuse of any kind or non-
compliance with other requirements detailed
in this manual.

Worn, broken, distorted, contaminated or

missing components must be replaced
immediately. Should such a repair become
necessary it is recommended that a request
for service advice be made to the nearest
Penlon accredited agent.

This device and any of its constituent parts

must be repaired only in accordance with
written instructions issued by Penlon
Limited and must not be altered or modified
in any way without the written approval of
Penlon Limited. The user of this equipment
shall have the sole responsibility for any
malfunction which results from improper
use, maintenance, repair, damage or
alteration by anyone other than Penlon or its
appointed agents.

USA and Canadian Federal Law restricts the

sale and use of this device to, or on the order
of, a licensed practitioner.

1
1. WARNINGS AND CAUTIONS
The following WARNINGS and CAUTIONS
must be read and understood before using
this ventilator.
WARNINGS
General Information
1. Personnel must make themselves
familiar with the contents of this
manual and the machines function
before using the ventilator.
Before Using the Ventilator
2. Before the ventilator is used clinically
for the first time, verify that the hospital
engineering department has carried out
an earth continuity test.
3. Excessive electronic noise caused by
other poorly regulated devices, such as
an electrocautery unit, may adversely
interfere with the proper functioning of
the ventilator.
To avoid this problem, do not connect
the ventilators power cord into the
same electrical wall outlet or adaptor
strip into which an electrocautery unit
is connected.
4. If used with a mains extension cord, the
unit may be subject to electro-magnetic
interference.
5. The driving gas supply must be clean
and dry to prevent ventilator
malfunction.
6. This ventilator is designed to be driven
by oxygen or medical air only. The
drive gas is set during manufacture
and the ventilator is calibrated for that
gas.
Before the ventilator is used clinically
for the first time, the commissioning
engineer must confirm that the
air/oxygen selection is set correctly for
the drive gas that is to be used.
The use of any other gas will cause
inaccurate operation and may damage
the ventilator, resulting in potential
injury to the patient.
2
7. The driving gas is discharged through
the opening in the back of the ventilator
control unit.
The discharged gas may contaminate
the environment, and should therefore
be extracted using a gas scavenging
system.
8. The bellows can only support
approximately 1 kPa (10 cmH2O)
differential positive pressure, above
which it may be dislodged from the
mounting ring, resulting in dangerous
malfunction of the ventilator.
Do not connect a positive end
expiratory pressure (PEEP) valve or
other restrictive device to the exhaust
port on the bellows base.
This would increase the pressure inside
the bellows and the bellows could
detach from the base, causing serious
malfunction.
9. Breathing System
The breathing system which conveys
gases from the anaesthetic machine to
the patient, and disposes of expired
gases, must conform to the
requirements of ISO 8835-2.
Because breathing systems require
frequent cleaning and disinfection they
are not a permanent part of the
anaesthetic ventilator and therefore
cannot be directly under the control of
the anaesthetic ventilator manufacturer.
However, we strongly recommend that
only breathing systems which have
been approved and authorised by the
manufacturer for use with AV-S should
be employed.
Do not use conductive breathing
system hoses.
When mechanical ventilation is
employed the patient breathing system
must be connected directly to a
pressure relief valve to prevent the
possibility of barotrauma.
10. The spirometer sensors are mounted
within the A200SP absorber. Do not fit a
spirometer sensor to any other location.
The device will not measure exhaled
volumes in any other position.
WARNINGS AND CAUTIONS
11. The operation of each alarm function
should be verified daily.
Periodically check the alarms at
clinically suitable intervals. If the
audible alarm or the visual indicator of
any alarm function fails to activate
during any alarm condition or fails to
reset after the alarm has been cleared,
refer the unit to an authorised service
technician.
12. Before using the ventilator check that
all connections are correct, and verify
that there are no leaks.
Patient circuit disconnects are a hazard
to the patient. Extreme care should be
taken to prevent such occurrences.
It is recommended that Safelock
fittings are used throughout the
breathing circuit.
13. Check that the cable between the
control unit and remote display screen
unit is connected before use.
Always use a cable type recommended
by the manufacturer.
Using the Ventilator
14. The AV-S ventilator is not intended for
use in intensive care applications.
15. This apparatus must not be used with,
or in close proximity to, flammable
anaesthetic agents.
There is a possible fire or explosion
hazard.
16. Anaesthesia apparatus must be
connected to an anaesthetic gas
scavenging system (AGSS) to dispose
of waste gas and prevent possible
health hazards to operating room staff.
This requirement must be observed
during test procedures as well as
during use with a patient.
The scavenging transfer and receiver
system must conform to ISO 8835-3.
Any problem arising from an
improperly functioning scavenging
system is solely the users
responsibility.
Do not use a scavenging system that
restricts drive gas flow when negative
pressure is exerted on it.
3
17. When the ventilator is connected to a
patient, it is recommended that a
qualified practitioner is in attendance
at all times to react to an alarm or other
indication of a problem.
18. In compliance with good anaesthesia
practice, an alternative means of
ventilation must be available whenever
the ventilator is in use.
19. It is recommended that the patient
oxygen concentration should be
monitored continuously.
20. If the drive gas supply pressure drops
below a nominal 241 kPa (35 psi), the
LOW DRIVE GAS SUPPLY alarm will
activate both audibly and visually.
Patient minute volume may be reduced
due to lowered flow rates
21. An audible alarm indicates an
anomalous condition and should never
go unheeded.
22. The characteristics of the breathing
circuit connected between the
ventilator and the patient can modify or
change patient ventilation.
To assist the maintenance of the
delivered patient tidal volume, the
ventilator control system software
includes:
A) a compliance compensation
algorithm,
B) a fresh gas compensation
algorithm.
However, patient ventilation must be
monitored independently from the
ventilator.
It is the responsibility of the user to
monitor patient ventilation.
23. Care must be taken to ensure that the
flow sensors are connected correctly
to the inspiratory and expiratory ports
of the absorber.
24. The Vent Inop (ventilator inoperative)
alarm indicates that one of the
following conditions has occurred:
a) The drive gas solenoid has failed.
b) The flow control valve has failed.
c) Internal electronic fault.
d) Internal electrical fault.
e) Software error.
WARNINGS AND CAUTIONS

Note that if a ventilator error is 31. Exterior panels must not be removed
detected, Ventilator Inoperative will be by unauthorised personnel and the
displayed on the front control panel apparatus must not be operated with
display. such panels missing.
There is a possible electric shock
25. The High and Low Airway Pressure hazard.
Alarms are important for patient care.
It is important that the sensor is Bellows Assembly
properly located in the expiratory limb
32. The valve seat on the patient gas
of the circuit - refer to section 5.1.10.
exhalation diaphragm valve in the base
of the bellows assembly must be
26. The patient must be continuously cleaned regularly. Note that the bellows
attended and monitored when assembly is built into the A200SP
Advanced Breathing Modes are in use. Absorber - please refer to User Manual
for this product.
Failure to keep the valve seat clean
User Maintenance
could result in the diaphragm sticking,
thus preventing exhalation.
Control Unit
27. Opening the control unit by
Great care must be taken not to
unauthorised personnel automatically
damage the precision surface of the
voids all warranties and specifications.
valve seat on the patient gas exhalation
diaphragm valve in the base of the
Prevention of tampering with the
bellows assembly.
control unit is exclusively the users
responsibility. If the control unit seal is
Never use any hard object or abrasive
broken, the manufacturer assumes no
detergent to clean it; use only a soft
liability for any malfunction or failure of
cloth.
the ventilator.
If the valve seat is damaged, the valve
will leak and may cause serious
28. For continued protection against fire
ventilator malfunction.
hazards, replace the two fuses only
with the identical type and rating of
fuse.
See section 4 for fuse rating.

29. If the internal battery is fully

discharged, the ventilator will not
function in the event of mains power
failure. The battery must be recharged
before the ventilator is used clinically,
otherwise backup cannot be
guaranteed.
See Appendix for battery maintenance.
See also CAUTION No. 7.

Used or defective batteries must be

disposed of according to hospital,
local, state, and federal regulations.

30. No oil, grease or other flammable

lubricant or sealant must be used on
any part of the ventilator in close
proximity to medical gas distribution
components.
There is a risk of fire or explosion.

4
WARNINGS AND CAUTIONS

CAUTIONS
NOTES
1. Do not sterilise the ventilator control unit.
The patient block assembly must be 1. The term cycle is used to designate the
removed from the control unit before transition to the exhalation phase.
sterilisation ( see section 6.2.5).
All other internal components are not 2. The term trigger is used to indicate the
compatible with sterilisation techniques transition to the inhalation phase.
and damage may result.

2. For ventilator components which require

sterilisation, peak sterilisation
temperatures should not exceed 134oC
(275oF) to prevent possible damage.
(See section 6).

3. Care must be taken not to let any liquid

run into the control unit; serious damage
may result.

4. The exhalation valve located in the

bellows base assembly and the paediatric
bellows adaptor must be cleaned and
sterilised separately. Note that the bellows
assembly is built into the A200SP
Absorber - please refer to User Manual for
this product.

5. Always check for correct fitment, and carry

out a full function test before clinical use, if
the bellows has been removed and
refitted for any reason. See section 6.
Note that the bellows assembly is built into
the A200SP Absorber - please refer to
User Manual for this product.

6. Damage may occur to the battery if it is

allowed to remain in a discharged state.
Check the battery frequently if the
ventilator is in storage (see Appendix 1).

7. Fresh gas compensation is disabled if :

a) The spirometry system is turned OFF
through the menu system, or
b) The spirometry system is not functioning
correctly.

8. Fresh gas mixture compensation is disabled

if :
a) The spirometry system is turned OFF
through the menu system, or
b) The spirometry system is not functioning
correctly.
c) The O2 monitor is switched OFF.
9. Circuit compliance is not activated until
Fresh Gas Compensation is switched
OFF.

5
WARNINGS AND CAUTIONS - Oxygen Monitor

Oxygen Monitor
NOTES
1. The O2 SENSOR FAULT alarm indicates
Note that the sensor for the oxygen that one of the following conditions has
monitor is built into the A200SP occurred.
Absorber - for additional information, a) Internal electrical fault
please refer to the A200SP User b) Software/electronics fault
Manual. c) Oxygen sensor fault.

2. The concentration read-out may, in

WARNINGS
1. We recommend calibration of the
oxygen monitor every time the system
is turned on, as a safety precaution.
2. Do not attempt to open the fuel cell.
The sensor contains small quantities
of :
a) electrolyte, classified as a harmful
irritant which is potentially hazardous,
and
b) lead.
certain conditions of excess pressure,
show a value above 100%.
To accommodate these conditions it is
possible to set the high alarm value up to
105% (see section 5).
3. To maintain maximum sensor life:
i) always switch off the anaesthetic
machine after use, to ensure that the basal
flow ceases.
ii) disconnect the breathing circuit after
use.

Used or defective cells must be 4. The accuracy of flow and volume

disposed of according to hospital, measurements may be reduced if the
local, state, and federal regulations. oxygen monitor is not in use.

3. ALWAYS check the integrity of the 5. Fresh gas mixture compensation is disabled
sensor assembly before use. if the oxygen monitor is switched OFF.

4. Once exhausted, the sensor must be

disposed of according to hospital,
local, state and federal regulations.

5. The sensor measures oxygen partial

pressure, and its output will rise and
fall due to pressure change.
An increase in pressure of 10% at the
sensor inlet will produce a 10%
increase in sensor output.

6. The oxygen sensor is not suitable for

sterilisation.
If contamination is suspected, fit a new
sensor (see section 6.4) and dispose of
the contaminated unit according to
hospital, local, state and federal
regulations.

CAUTIONS
1. Do not sterilise any oxygen monitor
component.

2. Do not autoclave or expose the sensor to

high temperatures.

3. If the sensor shows signs of being affected

by condensation, dry the sensor with soft
tissue.
Do not use heat to dry the sensor.
6
2. PURPOSE

The AV-S Ventilator is a software controlled,

multi-mode ventilator, designed for
mechanical ventilation of adult and
paediatric patients under general
anaesthesia.
In addition, in spontaneous mode, it can be
used to monitor spontaneously breathing
patients
It is designed for use in closed-circuit
anaesthesia.

Indications for use of the device:

The AV-S Ventilator is intended to provide

continuous mechanical ventilatory support
during anaesthesia. The ventilator is a
restricted medical device intended for use by
qualified trained personnel under the
direction of a physician. Specifically the
ventilator is applicable for adult and
paediatric patients.
The ventilator is intended for use by health
care providers, i.e. Physicians, Nurses and
Technicians with patients during general
anaesthesia.
The AV-S ventilator is not intended for use in
intensive care applications.

Oxygen Monitor
The Oxygen Monitor is intended to
continuously measure and display the
concentration of oxygen in breathing gas
mixtures used in anaesthesia, and is
intended for adult and paediatric patients.
The oxygen monitor is an integral part of the
ventilator.
The oxygen monitor is intended for use by
health care providers, i.e. Physicians,
Nurses and Technicians for use with patients
during general anaesthesia.

7
3. DESCRIPTION

3.1 General Description

The AV-S Ventilator is a pneumatically driven,
software controlled, multi-mode ventilator.

The ventilator is a time-cycled, volume/pressure

controlled, and pressure limited.

The ventilator has compliance compensation and a

user selectable option of an inspiratory pause fixed
at 25% of the inspiratory time.
In addition, fresh gas compensation and user
selectable gas mixture compensation is a standard
feature.
AV-S Ventilator
Ventilation Modes
Volume Mode - continuous mandatory ventilation
Pressure Mode - pressure controlled ventilation
Spontaneous, with advanced patient support - Spontaneous Mode Patient Support
SIMV, SMMV, PSV, PEEP SIMV - Synchronised Intermittent Mandatory Ventilation
SMMV - Synchronised Mandatory Minute Ventilation
Patient Monitoring PSV - Pressure Supported Ventilation
Airway pressure, measured from the expiratory PEEP - Positive End Expiratory Pressure
limb of the breathing circuit.

Tidal Volume and Minute Volume measurement is

provided by a dual spirometry system

An integral oxygen monitor system measures

oxygen concentration in the breathing circuit
inspiratory limb.

The print function provides a permanent record of

function activity for up to eight hours during a 1
procedure, or can be used to record waveforms.

Screen
Remote, arm-mounted, 210 mm (8.4 inch) high
definition, colour TFT screen, with single/dual
waveform display.
Bellows unit
The bellows unit (1) is built into the A200SP
absorber. A paediatric bellows assembly is
available as an option

Drive gas supply

The drive gas supply can be oxygen or air.
The supply must be at 310 to 689 kPa (45 to 100
psi).
Note that the drive gas is specified by the
customer, and set during manufacture.
Conversion from one drive gas to another must
only be carried out by an authorised service
engineer trained by the manufacturer.
8
DESCRIPTION

5 8 9 10 11 12 13 14 15
6

3 2 1
7
4

Interface and Parameter inputs

Control Unit 5. A200SP Absorber Bag/Vent
Rear Panel switch interface, and
Spirometer connector
6. Prima SP2 Interface connector -
(SP2 primary on/off switch)
Gas Connections
7. Pressure Monitor Port
1. Ventilator drive gas inlet
8. Input socket - Oxygen monitor
- connect to anaesthetic machine
sensor
auxiliary gas outlet
2. Bellows Drive Gas Output
Data and Printer Ports
- connect to bellows via A200SP
9. Data Output
absorber - see section 5.1.5
3. Outlet - Exhaust Valve 10. Output to remote display
- connect to scavenge system - see 11. Ethernet
section 5.1.6 12. USB
13. VGA
Electrical Connection 14. Printer port
4. Electrical mains input and fuse unit 15. RS232 (manufacturers use only)

NOTE
USB port is for access only by engineers
trained by the manufacturer.
All other data ports are read only.
For further information, please contact
your distributors service department, or
the manufacturer.

9
DESCRIPTION

3.2 Ventilation Cycle

This section provides a simplified description of the ventilation cycle.

1. Inspiratory Phase

The drive gas proportional

1 valve (1) in the control unit
opens.
4 Drive gas is delivered to the
bellows housing (2).
The patient proportional
valve (3) opens, and gas
3 5 flows through the bleed
valve. The back pressure
ensures that the exhaust
2 valve (4) is kept closed.
6
Drive gas pressure builds
7 up above the bellows (5),
which starts to move down.
The diaphragm (6) in the
bellows assembly base is
held closed, and patient gas
is forced out of the bellows
base (7) into the breathing
system.

2. Beginning of
Expiratory Phase
1
The drive gas proportional
valve (1) closes.
4 The patient proportional
valve (3) closes.
The exhaust valve (4) opens.
3
Patient gas returns to the
5 bellows (5).
As the bellows rises,
redundant drive gas is
pushed out through the
exhaust valve.

10
DESCRIPTION

3. End of
Expiratory Phase
4
With the bellows at the top
of its housing fresh gas
continues to flow.
5 To prevent a high pressure
build up the exhalation
6 diaphragm (6) lifts and
allows gas to exit through
the exhaust valve (4).

4. PEEP
Positive End
Expiratory
1 Pressure
(user selectable)

4 The patient proportional

valve (3) applies PEEP
pressure plus 20 cmH2O to
3 the exhaust valve, which
5
remains closed at this stage.
As fresh gas flows in the
patient circuit, any pressure
increase above PEEP
pressure in the bellows (5)
will cause gas to bleed past
the exhaust valve (4).
If there is a fall in pressure in
the breathing circuit, the
continuous flow from the
drive gas proportional valve
(1) helps maintain the set
PEEP pressure.

11
DESCRIPTION

A Pneumatic Flow
Diagram
1 3 to 7 bar

2
3 241 kPa (35 psi)

5 6
0 - 80 cmH2O

B 7 8 14
C

10 12

11 15

0 - 90 cmH2O
13

16
100 cmH2O

17 18

12
DESCRIPTION

3.3 Pneumatic System

3.3.1 System Operation
Refer to the pneumatic system diagram on the previous page.

A) Gas inlet manifold block

The AV-S Ventilator is designed to operate on a 310 - 689 kPa (45 -100 psi)
drive gas supply (oxygen or air - to customers requirement).

1. DISS Connector
The gas source is connected to the DRIVE GAS SUPPLY fitting on the
rear of the ventilator control unit.
The gas supply should be capable of a flow rate of 80 L/min while
maintaining a minimum pressure in excess of 310 kPa (45 psi).

2. Filter
The drive gas is filtered with a 40-micron Input Gas Filter which protects
the pneumatic components from incoming particulate matter.

3. The Low Supply Pressure Detector

The pressure switch is set at a predetermined level to detect a loss or
reduction of the input gas source pressure.
When the pressure falls below 235 kPa (35 psi 1 psi), the LOW
SUPPLY PRESSURE indicator will be displayed and the high priority
audible alarm will activate.

4. Input Pressure Regulator

Regulates the input drive gas to 260 kPa 21 kPa (38 psi 3 psi).

5. Cut-off Valve
The valve isolates the the gas supply :
a) when the ventilator is switched off
b) when a fault condition occurs.

6. Airway Pressure Sensor

Connected to expiratory limb of breathing circuit.

B) Pneumatic Control Manifold Block

7. Drive Gas Proportional Valve
8. Drive Gas Flow Sensor
9. Drive Gas Pressure Sensor
10. Low Pressure Regulator
11. Patient Proportional Valve
12. PEEP pressure sensor
13. Restrictor
The restrictor allows a flow of up to 2 L/min (<2 L/min bleeding)

C) Exhaust Manifold Block

14. Check Valve
15. Diaphragm Valve
16. Pressure Relief valve - Set to 100 cmH2O
17. Exhaust Port ( to AGSS)
18. Bellows drive gas outlet (to bellows assembly)

13
DESCRIPTION

3.4 Electrical System

Mains Supply
The mains supply inlet is designed for
connection to any mains voltage from 100 to
240 VAC and a frequency of 50 to 60 Hz,
without any adjustment.
The connector is a standard IEC type.

Back-up Battery
In the event of mains electrical failure, the back-
up battery cuts in automatically.

Standard battery:
A fully charged battery will power the ventilator
for approximately 30 minutes.

High-power battery (option):

A fully charged battery will power the ventilator
for approximately one hour.

See Appendix for battery care procedures.

14
DESCRIPTION

2
AV-S
Gas Mixture 1
.
cm H2O

.
O2 + air o IO
o
%O2 100
SMMV
33 20
4
Trigger
Freeze
cmH2O
Waveform
-1.0

Pmax Pmean
3
cmH2O cmH2O
24 10 5

Spont
secs Mode

Vm SET V MEAS SET Insp Time PEEP LIMIT

m
Litres Litres BPM Sec cmH2O cmH2O Standby

3.6 3.6 6 2 5 38
Touchscreen control

3.5 Control Panel

3.5.1 Touchscreen and Navigator Wheel / Push
Button
3.5.1.1 Control Panel
1. On/Off control
Switch On:
Short internal test sequence
Switch Off:
Power down sequence with progress indicator
2. Status indicators for electrical power
(mains/battery supply)
Yellow indicator - illuminated whenever power is applied
to the unit and internal battery is being charged
Green indicator - illuminates when the unit is switched on
3. Menu switch
The menu function provides access to user and service
pages, including alarm settings.
4. Alarm mute switch
30 second or 120 second alarm silence, depending on
alarm status.
Note also that some alarms are not mutable (see 3.11).

5. Navigator Wheel and Press Button

Turn the wheel to select a function or parameter, or to
alter the value of an active parameter.
Press to confirm the setting.

15
DESCRIPTION

3.5.1.2 Selecting Functions and Parameters

The functions/parameters shown on the screen can be
activated as follows:
a) touch the screen at the appropriate tab area.
b) rotate the navigator wheel and press it when the
indicator arrow is on the required parameter tab

Note that parameters default to factory-set values when

the ventilator is switched on and no further user
selection is made.

3.5.2 User Adjustable Parameters

Variable parameters can be altered by rotating

the navigator wheel.
When the required value is displayed, press
the active tab or the wheel to confirm the
setting.

Tidal Volume Range 20-1600 ml

Rate 4-100 bpm
I:E Ratio 1:0.3 to 1:8
PEEP 4-20 cmH2O
Can be set to OFF
Pressure Limit
Volume mode: 10-80 cmH2O
Pressure mode: 10-50 cmH2O

Alarm limits (user adjustable alarms only - see 3.11)

16
DESCRIPTION

3.5.3 Operational Capability

Tidal Volume, Rate, and I:E ratio settings
are all limited by a maximum inspiratory
flow of 75 L/min.

I:E Ratio
1:6 1:5 1:4 1:3 1:2 1:1 1:0.3

1.6
1.5
1.4
1.3
1.2
1.1
1.0
Tidal
Volume 0.9

(litres) 0.8 X
(Vt) 0.7
0.6

0.5
0.4

0.3
0.2
0.1

0 10 20 30 40 50 60 70 80

Rate (bpm)

The ventilator is capable of operating at the volumes and rates below

each I:E ratio curve.

Example
1. Select required volume (Vt) (e.g. 0.8 L)
2. Select rate (e.g. 10 bpm).
3. Select I:E ratio of 1:2.
The point X on the graph lies beneath the 1:2 ratio curve, and is therefore within the
ventilators capability.

17
DESCRIPTION

3.5.4 Output Compensation

Functions

WARNING
The AV-S automatically compensates for fresh
gas (spirometry On), fresh gas mixture
(spirometry and oxygen monitor On), and
altitude.
However, the actual tidal volume delivered to the
patient may be different to the ventilation
parameters set by the user, due to:
A) an extreme compliance condition,
B) a substantial system leak,
C) patient circuit pressure effects, or
D) extreme fresh gas flows

In addition, high fresh gas flows will lead to an

increased Vt being delivered to the patient.
The patient must be monitored independently
from the ventilator.
It is the responsibility of the user to monitor the
patient for adequate ventilation.

Fresh Gas Compensation

Adjusts delivered volume up to 60%
An alarm is triggered if the measured volume
varies by 50% from the set volume.
This function is user adjustable

NOTE
Fresh gas compensation is disabled if :
a) The spirometry system is turned OFF through the
menu system, or
b) The spirometry system is not functioning correctly.

Fresh Gas Mixture Compensation

- models with Spirometry
The spirometry system compensates for fresh gas
mixture - the user must access the menu system and
select the gas mixture that will be used for each
clinical procedure.

NOTE
Fresh gas mixture compensation is disabled if :
a) The spirometry system is turned OFF through the
menu system, or
b) The spirometry system is not functioning correctly.

If the O2 monitor is switched OFF, a 40% / 60%

mixture of O2/N2O is assumed.

Altitude Compensation
This function monitors ambient pressure, and
adjusts the delivered volume accordingly
NOTE Altitude compensation is automatically
applied during calibration of the oxygen monitor - see
section 5.3.2.

18
DESCRIPTION

3.6 Interface to Prima SP2/3 and

A200SP
The AV-S is designed to interface with the Prima
SP2 Anaesthetic Machine and the A200SP
Absorber.
B A
3.6.1 Prima SP2 Interface
The interface cable links the socket (A) on the
control panel to a socket on the rear panel of the
anaesthetic machine.
a) Turn the anaesthetic machine Gas
Delivery Switch to ON.
The ventilator will power-up.
b) While the anaesthetic machine power is
ON, the Ventilator can be turned OFF and
ON, using the ventilator On/Off switch, as
described in section 3.5.1.
c) Turn the anaesthetic machine Gas
Delivery Switch to OFF. The ventilator will
power-down.

3.6.2 A200SP Absorber Interface

The interface cable links the socket (B) on the
C
control panel to a socket (C) at the rear of the
absorber.

a) The A200SP is fitted with a sensor that

detects the position of the absorber
bag/vent control (D). D
The sensor signal cabling is routed
internally to connector (C) and a second
cable runs to the the rear of the AV-S
control unit.

b) Operation of the Bag/Vent control will

trigger automatic Mode switching on the
AV-S ventilator, as follows:

i) Ventilator in Volume or Pressure mode

Switching the absorber Bag/Vent control operation of the bag/vent control (from Vent to
from Vent to Bag
- the ventilator will change from Volume Mode, Bag, as described above):
or Pressure Mode, into Spontaneous Mode. - the ventilator will revert to that previous mode.

ii) Ventilator in Spontaneous Mode B) If the ventilator was in Standby Mode and
Switching the absorber Bag/Vent control Spontaneous Mode selected on-screen:
from Bag to Vent - the ventilator will default to Volume Mode.

A) If the ventilator was previously in Volume, or C) If the ventilator was put into Standby Mode
Pressure, or Special Mode, and Spontaneous after automatic mode switching to Spontaneous:
Mode was automatically selected by the - the ventilator will default to Volume Mode.

19
DESCRIPTION

3.7 Ventilation Modes

3.7.1 Standby Mode

Allows parameters to be set.

Some patient alarms are active:

High airway pressure (at 80 cmH2O)
High/Low Oxygen
Negative pressure
Incorrect Rate/Ratio

20
DESCRIPTION

3.7.2 Volume Mode

The ventilator delivers a mandatory set volume of Volume Mode Parameters
gas at preset, fixed breath intervals.
The Patient is making no respiratory effort. Tidal volume 20 - 1600 mL
Rate 4-100 bpm
3.7.2.1 Fresh Gas Compensation
I:E ratio 1:0.3 - 1:8
The delivered volume is adjusted by up to 60%.
PEEP 'Off' or adjustable 4-20 cmH2O
This delivered volume will consist of the volume
delivered from the ventilator bellows, plus the fresh Inspiratory pressure limit 10 to 100 cmH2O
gas flow from the anaesthetic machine fresh gas Inspiratory pause 25%
supply, minus any compliance loss and minus any (does not affect I:E ratio)
leak. Sigh Approximately 1.5 x
This gives a total actual inspired tidal volume. Set Vt is delivered
An alarm is triggered if the measured volume is once, twice, three
50% above or below the set volume
times or four times
This function is user adjustable
every 50 breaths (user
Altitude Compensation selects frequency)
This function monitors ambient pressure, and
adjusts the delivered volume accordingly

3.7.2.2 Operating Functions

Inspiratory Pause function:
This function creates a plateau that equates to
25% of the inspiratory time

Sigh function:
When the ventilator is in Volume Cycle mode the
"Sigh" option is available. When selected, this
option provides extra volume for 1 to 4 breaths in
50 (the user can select 1, 2, 3, or 4 breaths).
The extra volume will be approximately 50% above
the tidal volume set by the user.
Note that the High Volume Alarm is not triggered
when sigh is selected.

Volume measurement:
Volumes are measured if the Spirometry function is
selected.
Automatic High or Low volume alarms are
triggered if the measured volume is 50% above or
below the set volume.

User adjustable option

If the maximum pressure limit is achieved, the
ventilator cycles to the expiratory phase.

3.7.2.3 Volume Type Selection

Use the menu to switch between Tidal Volume and
Minute Volume.
NOTE Minute Volume is derived from a rolling average
during a 30 second period.

21
DESCRIPTION

3.7.3 Pressure Mode

3.7.3.1 Parameters
In pressure mode the ventilator delivers a flow
of gas to achieve a set pressure at fixed
breath intervals.
The Patient is making no respiratory effort.
This is a common mode for the ventilation of
small paediatric patients.

Inspiratory pressure 10 - 70 cmH2O

Rate 4 - 100 bpm
I:E ratio 1:0.3 - 1:8
PEEP 'Off' or adjustable: 4 - 20 cmH2O

Inspiratory decelerating flow is controlled by

the ventilator according to the pressure
setting.

There is no Inspiratory Pause function in

pressure mode.

3.7.3.2 Pressure Mode Operating Functions

Pressure mode defaults to a target pressure of
10 cmH2O at switch on.
A high Inspiratory Flow is used to achieve and
maintain the target pressure.
The exhaust valve operates to prevent excess
pressure.

22
DESCRIPTION

3.7.4 Spontaneous Mode

3.7.4.1 Parameters
The ventilator monitors the following patient parameters:
Rate
I:E ratio
Pressure
Tidal volume

In spontaneous mode the waveform displays are active,

and inspiratory oxygen levels are measured

3.7.4.2 Spontaneous Mode Operating Functions

Selection during Ventilation
Move the absorber Bag/vent switch to Bag - the ventilator will
switch from Pressure Mode or Volume Mode to Spontaneous
Mode (see 3.6.2 - Absorber Interface).

Functions
No mechanical ventilation
No Inspiratory Pause function

Patient Monitoring (Bag mode and Ventilator mode):

Airway pressures
FiO2,
Tidal volume,
Rate
I:E ratio,
Supply pressures

Advanced Ventilation Modes

Patient support modes are selectable from this mode -
see below, and section 3.7.5.

3.7.4.3 Patient Support Modes

The following support modes are selectable from the
'Special Modes' menu, and must be pre-select from the
main menu, whilst in Standby.
SIMV - Synchronised Intermittent Mandatory Ventilation
SMMV - Synchronised Mandatory Minute Ventilation
PSV - Pressure Supported Ventilation
CAUTION
The required patient support mode must be pre-selected in
Standby Mode (select from main menu), before it can be
activated during the ventilation of a patient.
Please refer to sections 3.7.5.1, 3.7.5.2, 3.7.5.3.

Note that if the system fails to detect an absorber

bag/vent switch, a confirm message will be displayed.

23
DESCRIPTION

3.7.5 Advanced Spontaneous

Breathing Modes
C E
D
3.7.5.1 SIMV
Synchronised Intermittent Pmax
Mandatory Ventilation
SIMV provides a minimum level of tidal
volume.
SIMV allows spontaneous breaths and a set PEEP
mandatory breath, synchronised with the 0 cmH2O
A A
start of a patient breath
B B

SIMV must be pre-selected in Standby SIMV - Spontaneously Breathing Patient

Mode A = Cycle Time (set from BPM)
Select Standby B = Trigger Window
Select Menu C = Spontaneous Breath
Select Special Modes D = Trigger
Select Support Mode E = Mandatory breath at the set tidal volume (Vt)
Select SIMV
Inspiratory flow in the Trigger Window (generated by the
Escape Menu
patients spontaneous breath) results in a synchronised
mandatory breath at a preset volume and rate
SIMV will be displayed on the main screen
when Spontaneous mode is selected or
triggered.
NOTE D
C
1. The trigger window is pre-set to 60% of
the BPM cycle time.
Pmax
2. The trigger is flow activated.
3. If Spirometry is disabled then SIMV is
not available
4. If the pressure limit and alarm are
activated the inspiratory phase is PEEP
terminated
0 cmH2O
A A
Activate SIMV during Ventilation B B
NOTE
SIMV will not function unless already pre-
selected in Standby Mode SIMV - No breathing effort by Patient
A = Cycle Time (set from BPM)
1. Select Special Mode on the display. B = Trigger Window
If the absorber Bag/Vent switch is not C = Flat Pressure Trace (no breathing effort)
detected, a message will appear: D = Mandatory breath at the end of the Trigger Window at the set Vt
SET ABSORBER TO VENT If the patient makes no effort to breathe during a cycle, a
Press the navigator wheel / push mandatory breath, at the end of the trigger window, will still be
button to confirm. delivered at the preset volume and rate.
2. Move the absorber Bag/vent switch to
Ventilator.
3. Check that SIMV is functioning
correctly.

SIMV Default Settings

The ventilator will default to pre-set values
for Tidal volume (Vt), Rate, Inspiratory Time
and Trigger Level, after selecting 'SIMV'.

Note:
1. Vt can be adjusted before SIMV is
confirmed.
2. The trigger setting is adjustable
between 0.7 and 4.0 L/min.
24
DESCRIPTION

3.7.5.2 SMMV
Synchronised Mandatory C E
Minute Ventilation D

SMMV provides a set level of minute Pmax

volume ventilation.
SMMV allows spontaneous breaths,
combined with a synchronised mandatory
breath, to achieve the set minute volume PEEP
0 cmH2O
A A
SMMV must be pre-selected in Standby B B
Mode
Select Standby
Select Menu SMMV - Spontaneously Breathing Patient
Select Special Modes A = Cycle Time (set from BPM)
Select Support Mode B = Trigger Window
Select SMMV C = Spontaneous Breath
Escape Menu D = Trigger
E = Mandatory Breath tidal volume.
SMMV will now be displayed on the main This is equal to Vm/BPM, minus the volume spontaneously
breathed during the cycle (this maintains the set Vm)
screen when Spontaneous mode is
selected or triggered. Inspiratory flow in the Trigger Window (generated by the
patients spontaneous breath) results in a synchronised
NOTE mandatory breath, ensuring that the set minute volume is
1. The trigger window is pre-set to 60% of achieved
the BPM cycle time.
2. The trigger is flow activated.
3. If the Spirometry is disabled then
SMMV is not available
4. If the pressure limit and alarm are
activated the inspiratory phase is
terminated. D
C
Activate SMMV during Ventilation
NOTE Pmax
SMMV will not function unless already pre-
selected in Standby Mode

1. Select Special Mode on the display.

If the absorber Bag/Vent switch is not PEEP
detected, a message will appear: 0 cmH2O
A A
SET ABSORBER TO VENT
B B
Press the navigator wheel / push
button to confirm.
2. Move the absorber Bag/vent switch to SMMV - No breathing effort by Patient
Ventilator. A = Cycle Time (set from BPM)
3. Check that SMMV is functioning B = Trigger Window
C = Flat Pressure Trace (no breathing effort)
correctly. D = Mandatory breath at the end of the Trigger Window (at the set Vm)

SMMV Default Settings If the patient makes no effort to breathe during a cycle, a
mandatory breath, at the end of the trigger window, will still be
The ventilator will default to pre-set values delivered at the preset volume and rate
for minute volume (Vm), Rate, Inspiratory
Time and Trigger Level, after selecting
'SMMV'.

Note:
1. Vm can be adjusted before SMMV is
confirmed.
2. The trigger setting is adjustable
between 0.7 and 4.0 L/min.
25
DESCRIPTION

3.7.5.3 PSV
Pressure Supported B
Ventilation
PSV assists each spontaneous breath to
achieve a preset pressure, thus reducing the
effort required to breathe.
Inspiratory flow (generated by the patients
spontaneous breath) results in synchronised
pressure support. PEEP
0 cmH2O
A A
PSV must be pre-selected in Standby
mode
Select Standby Mode C C

Select Menu
Select Special Modes PSV Pressure Supported Ventilation
A = Set Inspiratory Time
Select Support Mode
B = Pressure Support Level
Select PSV
C = Spontaneous Breath results in a synchronised pressure supported breath
Escape Menu
PSV is used to support spontaneously breathing patients ONLY
PSV will be displayed on the main screen If the patient makes no attempt to breathe, the ventilator will not
when Spontaneous mode is selected or provide support and the apnoea alarm will be activated
triggered.

Activate PSV during Ventilation

NOTE
PSV will not function unless already pre-
selected in Standby Mode

1. Select Special Mode on the display.

If the absorber Bag/Vent switch is not
detected, a message will appear:
SET ABSORBER TO VENT
Press the navigator wheel / push
button to confirm.
2. Move the absorber Bag/vent switch to
Ventilator.
3. Check that PSV is functioning
correctly.

NOTE
1. The trigger window is pre-set to 60% of
the BPM cycle time.
2. The trigger pressure is PEEP referenced.
3. If the Spirometry system is disabled, then
PSV is not available.
4. If the pressure limit and alarm are
activated the inspiratory phase is
terminated.

PSV Default Settings

The ventilator will default to pre-set values
for Support Pressure, Inspiratory Time, and
Trigger Level after selecting 'PSV' .

Note:
1. Support Pressure can be adjusted
before PSV is confirmed.
2. The trigger setting is adjustable
between 0.7 and 4.0 L/min.

26
DESCRIPTION

3.7.5.4 PEEP ( Positive End Expiratory Pressure)

The AV-S ventilator includes a microprocessor-controlled,

electronically integrated PEEP system, regulated by the
secondary pressure on the exhaust diaphragm ( see 3.2).
The ventilator controls PEEP by allowing flow from, or
delivering flow into the bellows drive circuit, thereby
maintaining the set pressure

NOTE
1. PEEP is electronically controlled
2. PEEP is variable from 4-20 cmH2O, in increments of 1
cmH2O
3. The display shows OFF when PEEP is not in use
4. PEEP is switched off when the ventilator is switched off.
5. PEEP is switched off during 'Spont' mode to minimise
patients breathing effort.

Selecting PEEP
1. Select by touching the screen tab PEEP, or using the
navigator wheel
The setting will flash.
2. Rotate the navigator wheel to set the required PEEP
pressure.
A confirm message will be displayed.
3. Press the Screen Tab, or Wheel to confirm.

Note that Electronic PEEP does not function in

Spontaneous Mode.

PEEP on/off sequence

Using the A200SP Absorber Interface - Ventilator
Mode Selection
1. Switch the ventilator to Volume Ventilation Mode
2. Select PEEP, and set pressure to the required level.
The PEEP display indicates pressure.
A
3. Switch the A200SP Absorber Bag/Vent control (A) to
the Bag position.
The ventilator automatically switches to Spontaneous
Mode.
PEEP is automatically switched off (does not function
in Spontaneous Mode)
PEEP display is blank.
4. Reset the Bag/Vent control Vent position.
The ventilator automatically switches to the mode
previously set by the user.
PEEP is Off.
PEEP display indicates Off.
5. Set the ventilator to Volume Ventilation Mode.
PEEP remains Off.
Select PEEP if required.
27
DESCRIPTION

3.8 On-Screen Menus

To Access:
Press the menu switch on the front panel to access
the following functions and parameters via drop-
down menus:

EXIT MENUS
O2 MONITOR & SPIROMETRY
FRESH GAS COMPENSATION: ON
SPECIAL MODES Menu Switch
WAVEFORM
ALARM SETTINGS
GAS MIXTURE: O2+AIR
USER SETTINGS
SERVICE MENU
Turn the wheel
To Exit: to scroll through
Press the menu switch on the front panel, or, select the menus.
EXIT MENUS and press the wheel. Press to enter
sub-menu
NOTE
The menu window will not be displayed if:
A) Control parameters (VT MEAS, BPM, I:E, PEEP, or
LIMIT) are enabled but not confirmed.
B) A display window is active

To Operate:
1. Rotate the navigator wheel clockwise to scroll
through the menu options - the cursor ( > )
aligns with each parameter in turn.
2. Press the wheel to enter the required sub-
menu.
3. Rotate the navigator wheel to change any
displayed values, and press to confirm.
4. To exit the menu display:
A) Press the menu switch on the front panel
B) Scroll to EXIT MENUS,
and press the navigator wheel.

NOTE
A) If confirmation does not take place within 8
seconds, the parameter reverts to its previous
value.
B) If another parameter is selected using the
touchscreen, the menu is de-selected.
C) While any menu is selected:
- the alarms are active,
- the ventilator can be switched off.

See Appendix 2 for a further information on the

Menu system.

28
DESCRIPTION

3.9 Spirometry

Spirometry can be enabled or disabled via the

on-screen menu system.
NOTE
If the spirometry system is turned OFF:
a) Fresh gas / fresh gas mixture
compensation is disabled.
b) Special Modes are disabled.

See Appendix 3 for a detailed description of the

spirometry system.

3.10 Display Waveforms

NOTE
1. The default waveform is always Pressure
v Time (cmH2O v seconds)
2. Wave Freeze is available when
ventilation is in progress

Second waveform
The second waveform can be displayed by
using the menu control or by touching the
waveform on screen.
Select from:
Volume v Time (litres v seconds)
Volume v Pressure (litres v cmH2O)
Compliance loop waveform
- First loop can be frozen
- Subsequent loops overlaid

Display Functions - Automatic Scale

adjustment

Y axis
a) The scale adjusts as Plimit is changed
(-20 to 40, 60, 80 cmH2O)
b) In Vol. v Time mode the scale adjusts as
Vt is changed
(0 to 0.5 L, 1.0 L, 2.0 L)

X axis
a) The scale adjusts as Rate is changed
(0 to 15 sec, 5 sec, 3 sec)
b) In Vol. v Pres. mode the scale adjusts as
Plimit is changed (-20 to 40, 60, 80
cmH2O)

29
 Alarm Priority Trigger Mute Set by:
time

3.11
NOTE
Ventilator Inoperative (vent inop) High Internal failure or Battery failure zero Automatic
Outlet blocked High Positive pressure exceeds 120 cmH2O, due to blocked exhaust valve outlet zero Automatic
Power About to Fail High Ventilator is using the battery, and the battery voltage is less than 10.2 v zero Automatic Alarms
Low Drive Gas Supply Pressure High Less than 235 kPa (35 psi +/-1 psi) zero Automatic
Low Bellows Drive Gas Pressure High Fails to reach target level 30 s Automatic
High Bellows Drive Gas Pressure High Exceeds calculated target level 30 s Automatic
High Continuous Airway Pressure High Breathing system pressure fails to return to below 30 cmH2O 120 s Auto
by the start of the next inspiratory phase
DESCRIPTION

High Airway Pressure High Pressure reaches set limit (10 to 80 cmH2O adjustable) 30 s User / Default

Low Airway Pressure High Breathing system pressure fails to reach minimum level (14 to 14 cmH2O) 120 s Automatic

Negative Airway Pressure High Breathing system pressure exceeds 10 cmH2O 120 s Automatic

Low Tidal Volume (Vt) High a) Measured Vt less than 50% of volume set 120 s User / Default
b) Spirometer disconnected

30
Low Minute Volume (Vm) High Calculated volume lower than 50% of volume set 120 s User / Default

Apnoea High In Spontaneous mode, no breath detected within 15 seconds 120 s Automatic
the front panel (see 3.8), and select ALARM SETTINGS.

High Tidal Volume (Vt) High Measured value exceeds 150% of set value 120 s User/Default

High Minute Volume (Vm) High Calculated value exceeds 150% of set value 120 s User / Default

High O2 Concentration High Measured O2 % exceeds set value 120 s User / Default
Low O2 Concentration High Measured O2 % lower than set value 120 s User / Default
O2 Sensor low output Low Sensor life exhausted zero Automatic
O2 sensor fault High Sensor disconnected 120 s Automatic

Incorrect Rate or Ratio Medium Settings outside 75 L/min 120 s Automatic

Mains Failure Low Mains power fails zero Automatic

Fully charged battery gives 30 mins use (60 mins with high power battery)
Battery Power Fail Medium Battery disconnected, or missing, or totally discharged 120 s
Low Battery Low Battery voltage has dropped below 11.2 v zero
Absorber cable fault (A100SP) Medium Disconnection or short circuit 120 s Automatic
User Adjustable Alarms - use the menu system to set the required limits - press the menu switch on

Printer not available Low Printer disconnected, or has no power, or has no paper zero

Priority identification:
High Priority: Five ascending tones - repeated Medium Priority: Three ascending tones - repeated Low Priority: Single tone - repeated
DESCRIPTION - O2 Monitor

3.12 Oxygen Monitor

The oxygen monitor continuously measures and indicates

the concentration of oxygen in the breathing system, and
triggers an alarm when the concentration varies from the
set levels.
3.12.1 System Description
The Oxygen Monitor uses a fast-responding, oxygen-
specific, self powered sensor that achieves 90% of final O2 Sensor Location
value in less than 10 seconds. Prima SP with A200SP Absorber

An external probe (1) is supplied with a 2 m (6 ft)

extendable cable.
The system has user-adjustable high-level and low-level
alarms with visual and audible indication of alarm
conditions.

Bacterial Filter
Always use a breathing system bacterial filter in the
expiratory limb of the breathing circuit to protect the
oxygen sensor and breathing system components
from contamination (see section 5).
CAUTION
Replacement/Disposal - always follow the instructions
supplied with the filter, and always replace at the
recommended interval.
1
3.12.2 The Oxygen Sensor
The oxygen sensor offers quick response, linear output
over the entire 0-100% oxygen range, and long service
life.

The sensor is a self-powered galvanic cell that generates

a current proportional to oxygen concentration.

The cell has a highly stable output over its operating life.
Significant output loss is only shown at the very end of its
life.
Typical sensor drift rates are less than 1% per month when
the sensor is exposed to gas in typical applications.

Sensor life:
approximately 1500 000 O2% hours at 20oC
(minimum one year in most normal applications).

Sensor lifetime is governed by the mass of lead available

to react with the oxygen and its rate of consumption. High
oxygen partial pressure and high temperature will increase
the sensor output current, thus shortening the operation
life.

At the point where all lead has been consumed, the output
will fall very quickly to zero over a period of two to three
weeks.

31
DESCRIPTION

3.12.3 O2 Monitor sub-menu

O2 Monitor sub-menu
ON/OFF
Turn the navigator wheel to switch between
O2 Monitor & Spiro
ON and OFF.
Press to confirm.
ESCAPE FROM MENU
Scroll to EXIT MENUS and press the wheel
> O2 MONITOR: on
to exit.
CALIBRATION: 100%
NOTE
HIGH ALARM SET: 105
The oxygen monitor automatically switches ON LOW ALARM SET: 18
and defaults to the previous values for high and SPIROMETER: on
low alarm settings when the ventilator is SPIRO CALIBRATION: 0 L/min
switched on.
Fresh gas mixture compensation is disabled if the
O2 monitor is switched OFF.

O2 Monitor sub-menu - calibration

CALIBRATION
Press the navigator wheel to initiate the O2 Monitor & Spiro
calibration procedure (see section 5.3.2 for
full procedure). ESCAPE FROM MENU
To exit the menu, scroll to EXIT MENUS O2 MONITOR: on
and press the wheel. > CALIBRATION: 100%
HIGH ALARM SET: 105
LOW ALARM SET: 18
SPIROMETER: on
SPIRO CALIBRATION: 0 L/min

HIGH ALARM SET

O2 Monitor sub-menu - alarms
LOW ALARM SET
Scroll to the required parameter and press
O2 Monitor & Spiro
the navigator wheel to activate.
Rotate the navigator wheel again to change
ESCAPE FROM MENU
the displayed value.
(see section 5.3.4 for full procedure). O2 MONITOR: on
CALIBRATION: 100%
High Alarm range: 19% to 105% > HIGH ALARM SET: 105
Low Alarm range 18% to 99% LOW ALARM SET: 18
SPIROMETER: on
The displayed figure will flash on and off. SPIRO CALIBRATION: 0 L/min
Press to confirm.
Scroll to EXIT MENUS and press the wheel
to exit.

32
DESCRIPTION - O2 Monitor

3.12.4 Display High Alarm Set

High-set, low-set, and oxygen concentration Value
percentage readings are displayed on screen.
Touch the tab to activate O2 menu

Oxygen Concentration
The display provides a direct readout of
measured oxygen concentrations in the range
o
o .
IO
.
0-100%. %O2 100
33 20
Low Alarm Set - limited within 18-99%
The oxygen percentage, set by the user, at
which the low alarm will be activated.
Measured O2 Low Alarm Set Value
To set the low oxygen alarm, see section 5.3.4.
concentration
High Alarm Set - limited within 19-105%
The oxygen percentage, set by the user, which
the high alarm will be activated.
Note that in certain conditions of excess
pressure, the readout may show a value above
100%.
To set the high alarm, see section 5.3.4.

3.12.5 Oxygen Monitor Alarms

HIGH O2 ALARM b) A high priority audible alarm will sound.

The high O2 alarm is triggered when the oxygen
concentration is 1% above the set value.
a) The High O2 Alarm visual indicator will
illuminate.
b) A high priority audible alarm will sound.
To cancel this alarm, the high alarm setting must
be equal to, or above the oxygen concentration.
The alarm can be muted for 120 seconds.
LOW O2 ALARM
The low alarm is triggered when the oxygen
concentration is 1% below the set value.
a) The Low O2 Alarm visual indicator will
illuminate.
b) A high priority audible alarm will sound.
To cancel this alarm, the low alarm setting must
be equal to, or below the oxygen concentration.
The alarm can be muted for 120 seconds.
O2 SENSOR FAULT
The alarm is triggered:
i) when either the oxygen sensor is
disconnected or approaching the end of its life.
ii) if the O2 concentration exceeds 110%.
To cancel this alarm, check the sensor
connection or replace the sensor.
The alarm can be muted for 120 seconds.
O2 SENSOR LOW
This alarm indicates the sensor has approached
the end of its life.
The legend O2 SENSOR LOW will be displayed,
and a low priority alarm (single note) will sound.
The sensor must be replaced as the output will
fall very quickly to zero within two to three weeks
of normal usage.
See section 6.5 for sensor replacement.
3.12.6 Oxygen Monitor Alarm Mute
In an alarm condition, pressing the ALARM
MUTE button will deactivate the audible alarm,
but the alarm message display will remain on
screen.
The switch will illuminate, and a single note will
sound.
The alarm mute can not be operated:
a) Until the mute time is over, or the alarm
condition has been rectified.

a) The message O2 SENSOR FAULT will be b) When O2 concentration drops below 18%.
displayed.
33
4. SPECIFICATION

4.1 Application Ventilation for use in anaesthesia.

4.2 Internal Compliance

Adult bellows 3 ml/cmH2O (nominal)
Paediatric bellows 2 ml/cmH2O (nominal)

4.3 Physical
Size (mm)
- control unit only 290 wide x 300 deep x 185 high
- with adult bellows 290 wide x 300 deep x 385 high
Screen Size 210 mm (8.4") TFT
Weight - control unit only 7.6 kg
- with adult bellows 9 kg
Bellows
Adult (Latex free): 20 ml - 1600 ml
Paediatric : 20 - 350 ml
(Note - latex free paediatric available as option)

Power 100 - 240 VAC, 50 - 60 Hz

Battery Back-up: 30 minutes (assumes fully charged battery)
Note: Optional 1 hour back-up battery is fitted to some models
Drive Gas Oxygen or Air
(dry, and oil free) at 45 to 100 psi (310 to 689 kPa).

4.4 Alarms
Alarm Mute 30 or 120 seconds (see 3.11)
Apnoea Flow referenced (no breath detected within 15 seconds)
Low Drive Gas Pressure Less than 235 kPa (35 psi)
High Continuous Airway Pressure Above 30 cmH2O at start of cycle
Low Pressure 4 - 14 cmH2O PEEP referenced
Incorrect Rate or Ratio
Mains Failure Fully charged standard battery provides 30 mins (nominal)
backup
Fully charged high-power battery (option) provides one
hour (nominal) backup
Low Battery 5 minutes use
Ventilator Inoperative Internal or Battery Failure
Outlet Blocked Exhaust valve outlet blocked
Alarms - User Adjustable
Low Tidal Volume Measured value is below 50% of volume set
Range: 0 - 1600 ml
High Tidal Volume Measured value exceeds 150% of volume set
Range: 20 - 1600 ml
Low Minute Volume Calculated value is 50% below volume set
Range: 0 - 10 L
High Minute Volume Calculated value exceeds 150% of volume set
Range: 0 - 30 L
Low and High O2 Concentration 18% - 105%
High Airway Pressure 10 - 80 cmH2O adjustable

34
SPECIFICATION

4.5 Functional

Tidal Volume
Adult bellows 20 to 1600 ml (10%)
Paediatric bellows 20 to 350 ml (10%)
At ambient temperature of 20oC (+/-10%) and ambient atmosphere of 101.3 kPa (+/-10%).

Minute Volume 0 to 30 L
Rate 4 - 100 bpm
I:E Ratio 1:0.3 - 1:8
Pressure Limit 10 - 100 cmH2O
Fresh Gas Compensation Automatic Tidal Volume adjustment

Modes Off
Standby
Volume Cycle
Pressure Controlled
Spontaneous (includes advanced breathing modes)

Pressure Control 10 - 70 cmH2O

Inspiratory Flow 2 - 70 L/min

Spontaneous Mode Active Volume and Pressure Alarms,

Advanced Breathing Modes selectable (see section 4.6)

Electronic PEEP 4 - 20 cmH2O

Oxygen Monitor Fuel Cell type

For full specification, see section 4.15.

Spirometry - Resolution 10 ml

Ventilator Performance - accuracy of delivered volumes

>300 ml 20%
>100 ml <300 ml 20%
<100 ml 50%.

NOTE
The ventilator is designed for use with Spirometry ON.
Accuracy of delivered volumes with Spirometry OFF may vary from the figures given above.

35
SPECIFICATION

4.6 Advanced Spontaneous Breathing Modes (SIMV, SMMV, PSV)

Trigger (PEEP Referenced) 0.7 to 4 L/min
Trigger Window Set 60% of Expiratory Time
Vt and Vm As Volume Mode
Insp Time (Ti) 0.5 to 5 secs
Support Pressure 3 to 20 cmH2O
Default settings

Volume Vt BPM I:E Pmax

Adult 600 ml 10 1:2 38 cmH2O
Paediatric 150 ml 15 1:2 38 cmH2O

Pressure Vt BPM I:E P-target

Adult 600 ml 10 1:2 10 cmH2O
Paediatric 150 ml 15 1:2 10 cmH2O

SIMV Vt BPM Insp time Trigger

Adult 600 ml 6 2 sec 1 L/min
Paediatric 200 ml 10 1 sec 1 L/min
SMMV Vm BPM Insp time Trigger
Adult 3.6 L 6 2 sec 1 L/min
Paediatric 2L 10 1 sec 1 L/min
PSV Support Pressure Insp time
Adult 10 cmH2O 1 L/min
Paediatric 10 cmH2O 1 L/min

4.7 Disinfection and Sterilisation Patient Block assembly can be sterilised if

necessary - section 6.
NOTE : The bellows assembly, oxygen monitor
sensor, and spirometer sensors are built into the
A200SP Absorber - for information, please refer to
the User Manual for A200SP.

4.8 Bacterial Filter None (always use a bacterial filter in the

breathing system to protect the oxygen sensor -
see section 5.1.4)

4.9 Fail Safe Mechanism Battery back-up in case of mains electricity

failure
Gas shut-off in the event of electronic failure

4.10 Reliability MTBF: 5x106 to 50x106 cycles

4.11 Waveform Tests Not applicable
4.12 Volume Tests Not applicable

4.13 Mobility and Mounting

(A) Mobility Secure mounting required

(B) Mounting Control unit and remote screen are mounted on
anaesthetic machine .
The bellows assembly is built into the A200SP
Absorber.

4.14 Fuse (mains supply) Two fuses, Type T 2AH

2 A, 250 V rating, 20 mm, anti surge, ceramic.

36
SPECIFICATION - O2 Monitor

4.15 Oxygen Monitor

Measurement Range: 0-l00%

Resolution: 1%

Accuracy and Linearity: 2% of full scale (at constant temperature and pressure)
Response Time: 90% of final value in approximately 10 seconds
(air to 100% O2)

Operating Temperature: 50F to 100F (10C to 38C)

Storage Temperature: 23F to 122F (-5C to 50C)
Relative Humidity Range: 5%-95% (non-condensing)

Battery Back-up: As per ventilator

High Priority Alarm: Flashing, 5 audio pulses with 6 seconds repeat time.
Medium Priority Alarm: Flashing, 3 audio pulses with 24 seconds repeat time
Low Priority Alarm: Static with single beep sound
Alarm Mute: 30 seconds for high priority alarm
120 seconds for medium priority alarm

Low Alarm Set Range: 18%-99% ( 1%)

High Alarm Set Range: 19%-105% ( 1%)

Cable length: 2 m (6 ft), fully extended

Sensor
Type: Galvanic fuel cell sensor (0-100%)
Life: 1500000 O2% hours
(One year minimum in typical applications)

Interference Gases and Vapours (in 30% Oxygen, 70% Nitrous Oxide)

Interference Volume % Dry Interference in O2%

Nitrous Oxide 80% <1%

Carbon Dioxide 5% <1%
Halothane 5% <1%
Enflurane 5% <1%
lsoflurane 5% <1%
Sevoflurane 5% <1%

37
SPECIFICATION - O2 Monitor

Oxygen Monitor - continued

Humidity Effects
Sensor output is relatively unaffected by prolonged operation in either high or very low relative
humidity.
If the sensor shows signs of being affected by condensation, dry the sensor with soft tissue.
CAUTION DO NOT use heat to dry the sensor.

Temperature Effects
The sensor has a built-in temperature compensation circuit, and is relatively unaffected by
temperature changes within the operating temperature range given above.

Pressure Effects
The sensor measures O2 partial pressure, and its output will rise and fall due to pressure change
(e.g. changes in barometric pressure, or breathing system pressure).
An increase in pressure of 10% at the sensor inlet will produce a 10% increase in sensor output.

NOTE
Altitude compensation is automatically applied during calibration.

38
5. PRE-OPERATION PROCEDURES
5.1 Ventilator Set-up
5.1.1 Mounting the Ventilator
The remote screen is mounted on an
adjustable arm, with the control unit
mounted at the rear or side of the
anaesthetic machine.
Option control unit location
Preferably, mount the control unit
permanently on the shelf of the anaesthesia
machine or on a strong bracket. This will
protect the unit from accidental fall and
disconnection of hoses and cables.
To fit the ventilator control unit permanently
on a mounting bracket:
1. Align the four mounting feet over the
mating holes in the bracket.
2. Use the four M4 screws supplied with
the mounting bracket kit, inserted
through the bracket and rubber feet
and screwed into the threaded inserts
in the base of the ventilator.
Only use the screws supplied with
the kit.
Pole-mount type mounting brackets and side
frame brackets are available from the
manufacturer.
Bellows unit
The bellows unit is built into the A200SP
absorber.
5.1.2 Electrical Power Connection
Before connecting the ventilator to the mains
supply, check that the power supply is within
the correct rating as stated on the label on
the rear of the control unit.
WARNING
Excessive electronic noise caused by other,
poorly regulated devices, such as
electrocautery, may adversely interfere with
the proper functioning of the ventilator.
To avoid this problem, do not connect the
ventilator power cord into the same electrical
wall outlet or strip into which an
electrocautery unit is connected.
39
5.1.3 Ventilator Gas Supply
1. Verify the drive gas specified for the
ventilator (oxygen or air).
Always use the correct drive gas.
2. Connect the drive gas inlet port on the
rear of the control unit to a dry, oil free
supply.
Supply pressure range:
45 to 100 psi
(3.1 - 6.9 bar, 310 - 689 kPa)
OXYGEN SUPPLY:
a) O2 cylinder,
b) Anaesthetic machine O2 auxiliary gas
outlet,
c) O2 pipeline supply from a wall outlet.
AIR SUPPLY:
a) Air cylinder,
b) Anaesthetic machine Air auxiliary gas
outlet
c) Air pipeline supply from a wall outlet.
Supply pressure should be monitored
by a separate means, e.g. pressure
gauge on anaesthetic machine or
supply line.
NOTE: It is possible to reconfigure the
ventilator for use with a different drive gas
to the gas originally specified. This work
must be carried out by an engineer trained
by the manufacturer.
5.1.4 Breathing System Schematic
The following page contains a schematic
diagram showing the cables and tubing for an
AV-S ventilator mounted on a Prima SP2
anaesthetic machine with an integral A200SP
Absorber.
PRE-OPERATION PROCEDURES

Hoses and Cables Schematic

AV-S and A200SP Absorber

3 25 31
23
2 26
24
20 19 30

18

12

4 1

11 10
21
16 27 13
14
28 5 22
26
29
15 17 12
6

9
7
8

Note
1. AV-S has spirometry and oxygen monitor.
2. Interface cabling is shown for connection
to Prima SP2 On/Off switch and A200SP
Bag/Vent switch.

40
 PRE-OPERATION PROCEDURES

1. Bellows
2. Ventilator Control Unit
3. Outlets to Anaesthetic Gas Scavenging System (AGSS)
4. Bacterial Filter
5. Absorber valve block
6. Heat and moisture exchanger (a combined unit with a bacterial filter can be used - see 5.1.9)

7. Patient
8. CGO Block on anaesthetic machine (Fresh Gas Supply)
9. Auxiliary Outlet on anaesthetic machine (Drive Gas Supply)
10. Flow sensor - expiratory
11. Flow sensor - inspiratory
12 Connectors - sensor - pressure monitor
13. Expiratory Valve - Absorber
14. Inspiratory Valve - Absorber
15. Inlet - from Ventilator Bellows
16. Connector - Reservoir Bag
17. Inlet - Absorber - Fresh Gas Supply
18. Drive Gas Inlet - Ventilator
19. Drive gas Outlet - ventilator control unit to bellows
20. Outlet - Exhaust Valve
21. Inlet - Bellows Drive Gas
22. Outlet - to breathing system
23. Input socket - Oxygen monitor sensor
24. Input socket - Prima SP interface
(SP on/off switch)
25. Input socket:
(i) A200SP Absorber Bag/Vent control position
(ii) Spirometer sensor signal
26. Interface connections on Prima SP2 and A200SP
27. APL Valve
28. Outlet from APL Valve to AGSS
29. Oxygen sensor
30. Remote screen unit
31. Cable - control unit to screen

41
PRE-OPERATION PROCEDURES

5 8 9 10 11 12 13 14 15
6

3 2 1
7
4

Interface and Parameter inputs

Control Unit 5. A200SP Absorber Bag/Vent
Rear Panel switch interface, and
Spirometer connector
6. Prima SP2 Interface connector -
(SP2 primary on/off switch)
Gas Connections
7. Pressure Monitor Port
1. Ventilator drive gas inlet
8. Input socket - Oxygen monitor
- connect to anaesthetic machine
sensor
auxiliary gas outlet
2. Bellows Drive Gas Output
Data and Printer Ports
- connect to bellows
9. Data Output
( on Prima SP2 with A200SP absorber
- connect to absorber - see section 10. Output to remote screen
5.1.5) 11. Ethernet
3. Outlet - Exhaust Valve 12. USB
- connect to scavenge system 13. VGA
14. Printer port
Electrical Connection 15. RS232 (manufacturers use only)
4. Electrical mains input and fuse unit
NOTE
USB port is for access only by engineers
trained by the manufacturer.
All other data ports are read only.
For further information, please contact
your distributors service department, or
the manufacturer.

42
PRE-OPERATION PROCEDURES

5.1.5 Bellows drive gas hose

1. Prima SP2 with A200SP absorber:
Connect a 16 mm diameter corrugated hose
between the ventilator control unit drive gas
outlet (labelled: DRIVE GAS) and the outlet (1)
at the rear of the A200SP absorber.
2. All other AV-S configurations:
Connect a 16 mm diameter corrugated hose
between the control unit drive gas outlet
(labelled: DRIVE GAS) and the bellows base
DRIVE GAS inlet port.
1
5.1.6 Anaesthetic Gas Scavenging System
1. Connect the EXHAUST valve port on the
control unit to a properly functioning
scavenging system.
Use a 19 mm hose.
2. Fit a 10 cmH2O pressure relief valve between
the exhaust valve port and the inlet port of the
AGSS receiver.
Note that the diaphragm valve under the
bellows is connected internally to the
EXHAUST port to facilitate the discharge of
excess breathing gas at the end the expiratory
phase.

WARNING
Do not use a scavenging system that restricts drive
gas flow when negative pressure is exerted on it.
Applying negative or positive pressure to the bellows
exhaust port results in positive pressure in the patient
breathing system.
Therefore, the scavenging system must not generate
more than 0.5 cmH2O positive or negative pressure
when connected to the ventilator.
Any problem arising from an improperly functioning
scavenging system is solely the user`s responsibility.

1
5.1.7 Remote Screen
Attach the DVI cable supplied with the screen
between the interface connectors (1) on the rear of
2
the control unit and screen.
WARNING
Check that the cable between the control unit and
remote display screen unit is securely connected
before use.
Always use a cable type recommended by the
manufacturer.

5.1.8 Printer
Attach a printer to the printer port (2) if a printed
output of the ventilator function is required.

43
PRE-OPERATION PROCEDURES

5.1.9 Breathing System

1. Connect the ventilator bellows base BREATHING
SYSTEM port to the breathing system.

2. a) Use a breathing system bacterial filter in the

expiratory limb of the breathing circuit to protect
the oxygen sensor.
b) Use a heat and moisture exchanger (HME) at
the patient Y piece.
(a combined HME / bacterial filter can also be
used, but note that the expiratory limb bacterial
filter is still required)
CAUTION
Replacement/Disposal - always follow the instructions
supplied with the filter or HME.
Fit new components at the recommended interval.

3. Connect a 2-litre breathing bag to the patient

connection as a test lung.
4. Close the anaesthetic machine APL valve.

5.1.10 Spirometer
5.1.10.1 Flow sensors fitted to an A200SP
Absorber mounted on a PrimaSP2

1. Use a breathing system bacterial filter - see

section 5.1.9, operation 2.
CAUTION
Replacement/Disposal - always follow the instructions
supplied with the filter.
Always renew components at the recommended
interval.
2. The two spirometry flow sensors are mounted
within the A200SP Absorber in the inspiratory
and expiratory airways.
A
3. Connect the cable assembly between the
connector at the rear of the A200SP Absorber (A)
and the the socket (B) at the rear of the
Ventilator control unit.
4. Check that the cable connections are secure. B
NOTE
A) If the connections are incorrectly made, the ventilator
will alarm LOW TIDAL VOLUME or HIGH TIDAL
VOLUME.

B) To allow the ventilator to be used in the event of

damage, or non-functioning of the spirometer heads,
turn off the spirometry function - see MENU function,
section 3.5.

If the spirometer is switched OFF:

a) Fresh gas compensation is disabled
b) Fresh gas mixture compensation is disabled.
c) Patient support function is disabled.

44
PRE-OPERATION PROCEDURES

5.1.10.2 Spirometer Calibration

Flow sensors fitted to an A200SP
Absorber mounted on a Prima SP 3

The Spirometry sensor heads must be calibrated

with zero flow going through them.

1. Turn the anaesthetic machine gas flow off at

1
the Gas Delivery on/off switch. This will stop
all gas flows (including the AHD basal flow).
This will also turn the AV-S off.

2. Turn the AV-S on at the ventilator (Do not use

the Prima SP Gas Delivery switch).
or,
Disconnect the fresh gas hose from the CGO
block on the anaesthetic machine.

3. Remove the breathing circuit hoses from the 2

inspiratory and expiratory connectors (1) on
the absorber.

4. Disconnect the hose that connects the APL

valve outlet (2) at the rear of the manifold
block to the AGSS receiver (or disconnect at
receiver).
o IO
o . . On/Off Switch
5. a) Remove the bag, and set the Bag/Vent
control (3) to Bag position.
or, Alarm Mute
b) Ensure that the ventilator bellows is
empty, Menu Switch

6. Calibrate the spirometer via the ventilator

menu procedure.

7. Press the menu switch on the front panel.

8. Scroll down the main menu and select O2 Navigator
MONITOR & SPIROMETRY. Wheel and
Press Button
9. Select SPIRO CALIBRATION.

10. Press the wheel to initiate calibration.

11. Calibration is completed.

O2 Monitor & Spiro
12. Scroll to ESCAPE FROM MENUS.
ESCAPE FROM MENU
O2 MONITOR: on
13. Press the wheel to confirm.
CALIBRATION: 100%
HIGH ALARM SET: 105
LOW ALARM SET: 18
SPIROMETER: on
> SPIRO CALIBRATION: 0 L/min
45
PRE-OPERATION PROCEDURES

5.1.11 Pressure Monitor Connections

WARNING
The High and Low Airway Pressure Alarms are
important for patient care.
The connection point must be properly
located in the expiratory limb of the breathing
system.

1. PATIENT PRESSURE port (A) on the

rear panel of the control unit:
Use the tubing assembly supplied by A
the manufacturer to connect to the
expiratory limb of the breathing system,
close to the circle system expiratory
valve.
B

2. Push-fit, self sealing connectors (B)

Push in the tube as far as possible
Do not use excessive force. X

The connector end piece X will also

move inwards.

Pull the tube carefully outwards.

The end piece X will be pulled
outwards to the locked position.

3. Connect the tubing (with adaptor, Part

No 053049) to the push-fit, self-sealing
connector (C) at the rear of the
A200SP Absorber.

46
PRE-OPERATION PROCEDURES

7
4

6
2

5.1.12 Bellows Assemblies Paediatric Bellows Assembly

Note that the bellows assembly is built into 1. Remove the adult bellows housing
the A200SP Absorber. For additional (1) - twist carefully counterclockwise
information, please refer to the user manual until the bayonet tabs become free,
for that product. then lift up from the base (2).
Remove the bellows (3).
CAUTION 2. Fit the paediatric adaptor (5) - press
Always ensure correct fitment of bellows (see the adaptor into the ventilator bellows
illustration above), and carry out a full function assembly base (2).
test before clinical use, if a bellows is removed
3. Fit the paediatric bellows (6) to the
and refitted.
adaptor.
Check for correct assembly, as
1. Remove the bellows housing (1). illustrated (4).
Twist carefully counterclockwise until 4. Fit the paediatric bellows housing (7)
the bayonet tabs become free, then lift to the base by pushing down, then
up from the base (2). twisting clockwise until the bayonet
2. Remove the bellows (3). tabs completely engage.
3. Refit the bellows and check for 5. Function test the ventilator - section
correct assembly, as illustrated (4). 5.3.1.
4. Fit the bellows housing by pushing
down, then twisting clockwise until the
bayonet tabs completely engage.
5. Function test the ventilator - section
5.3.1.
NOTE
If there is any malfunction, the ventilator must
NOT be used.
If the problem cannot be rectified, the ventilator
must be checked by an engineer trained by the
manufacturer.

47
PRE-OPERATION PROCEDURES

5.2 Pre-use Checklist

5.2.1 Daily Checklist
The following tests must be carried out at the
beginning of every working day:

Alarm System
WARNING
The operation of each alarm function should be verified
daily.
If the audible alarm or the visual display for any alarm
function fails to activate during any alarm condition or
fails to reset after the alarm has been cleared, refer the
unit to an authorised service technician.

Back-up Battery
WARNING
If the internal battery is fully discharged, the ventilator
will not function.

Recharge the battery before the ventilator is used

clinically.
Charging the battery for 14 hours from a discharged
state will allow a minimum of 30 minutes of
continuous operation.
Connect the ventilator to a mains power supply. The
mains power indicator will illuminate to show that the
battery is being charged (it is not necessary to turn on
the ventilator).

Ventilator internal test o IO

o . . 1
Press the ON/OFF switch (1).
A three-second internal test is initiated:
1. The power -up screen is displayed.
2. The audible alarm sounds.
3. The ventilator reverts to STANDBY mode if no
selection is made.

NOTE special operating system on ventilators interfaced

with Prima SP2 (see section 3.5.2).
a) Turn the anaesthetic machine Gas Delivery Switch to
ON - the ventilator will power-up.
b) While machine power is ON, the Ventilator can be
turned OFF and ON, using the ventilator On/Off switch.
c) Turn the machine Gas Delivery Switch to OFF. The
ventilator will power-down.

Calibrate the Spirometer - 5.1.10.2

Calibrate the O2 Monitor - 5.3.2

48
PRE-OPERATION PROCEDURES

Function Test 9. Occlude the patient Y -piece.

1. Set the AIRWAY PRESSURE LIMIT
to 50 cmH2O.
2. PRESSURE TRANSDUCER
connection
Check that the port on the rear of the
control unit is correctly connected to
the port on the rear of the absorber
assembly (see section 5.1.10).
3. Connect a 2-litre breathing bag to the
patient connection as a test lung.
The HIGH AIRWAY PRESSURE
alarm should be activated.
The peak pressure read on the
breathing system pressure gauge is
the maximum working airway
pressure limit and should agree with
the setting.
10. Open the patient Y -piece to ambient
pressure.
At the second cycle, the LOW
AIRWAY PRESSURE alarm should
be activated.

4. Adult bellows only: 11. Select STANDBY mode

Set the tidal VOLUME to 600 ml; Before using the ventilator clinically,
RATE to 10 bpm, and I:E RATIO to check that all connections are correct,
1:2.0. and verify that there are no leaks.

5. Use the O2 flush button on the NOTE

anaesthetic machine to fill the If there is any malfunction, the ventilator must
bellows. NOT be used.
6. Select VOLUME CYCLE mode. If the problem cannot be rectified, the ventilator
must be checked by an engineer trained by the
7. The delivered tidal volume indicated manufacturer.
on the scale printed on the bellows
housing should be approximately 600
ml.
If the delivered tidal volume is less
than 500 ml or greater than 700 ml,
refer the ventilator to an engineer
trained by the manufacturer.

8. Set a basal flow only on the

anaesthetic machine.
Check the bellows after 10 breaths -
the bellows should return to the top of
the housing.
Failure to return to the top of the
housing indicates a leak in the
breathing circuit.
Rectify the leak before clinical use.

49
PRE-OPERATION PROCEDURES

5.2.3 Weekly Checklist

At least every week, in addition to the daily
function test, the following checks must be
carried out:

Alarms
1. Select STANDBY MODE.

2. Unplug the mains power cable from

the AC outlet.
The MAINS FAILURE alarm should
activate.

3. Reconnect the mains power cable to

the AC outlet. The alarm should turn
off.

4. Disconnect the drive gas supply hose.

The LOW SUPPLY PRESSURE
alarm should activate.

NOTE
If there is any malfunction, the ventilator must
NOT be used.
If the problem cannot be rectified, the ventilator
must be checked by an engineer trained by the
manufacturer.

Bellows
Check the condition of the bellows and
exhalation diaphragm valve.
Note that the bellows assembly is built into
the A200SP Absorber - please refer to the
user manual for this product.

50
PRE-OPERATION PROCEDURES - O2 Monitor

5.3 O2 Monitor System Set-up

5.3.1 Installation
Fit the probe (A) to the A200SP absorber.
Connect the cable to the input socket (B) on
the back of the AV-S ventilator control unit

NOTE The anaesthetic machine gas control switch

must be in the ON position for gas delivery.

WARNING
The sensor contains a small quantity of
electrolyte, classified as a harmful irritant which
is potentially hazardous.
Do not attempt to open a cell.
ALWAYS check the integrity of the sensor
assembly before use.
Once exhausted, the sensor must be disposed A
of according to hospital, local, state and federal
regulations. B
NOTE
To maintain maximum sensor life:
i) always disconnect the breathing circuit after use.
ii) Switch off the anaesthetic machine to cut-off the
basal flow through the system.

Bacterial Filter
Use a breathing system bacterial filter in the
expiratory limb of the breathing circuit to
protect the oxygen sensor (see section 5.1.9).
CAUTION
Replacement/Disposal - always follow the
instructions supplied with the filter, and always
replace at the recommended interval.

5.3.2 Calibration
The new unit must be calibrated before clinical
use.
Thereafter, as a safety precaution, we
recommend calibration of the unit every
time the system is switched on.

Calibration must also be performed:

A) when the sensor is replaced
B) when point-of-use elevation changes by more
than 160 m (500 ft).
NOTE
Altitude compensation is automatically applied
during calibration.

We recommend calibration with a 100%

oxygen standard source, at a pressure and
flow similar to your application.

51
PRE-OPERATION PROCEDURES - O2 Monitor

5.3.2.1 Calibration - Using 100% Oxygen

AV-S ventilator mounted on a Prima SP2

anaesthetic machine fitted with a A200SP
absorber

Calibrate with the sensor in position within the absorber.

1. Detach the absorbent canister (1).

2. Remove the breathing circuit hoses from the

inspiratory and expiratory connectors (2) on 2
the absorber.
This will give a free flow of oxygen through the
sensor. 1

3. Switch on the ventilator (3) and the

anaesthetic machine gas delivery switch.
The oxygen monitor automatically switches
ON when the ventilator is switched on.
Ensure that all vaporizers are OFF.
o IO
o . .
4. Apply 100% oxygen only, at 5 L/min, from the %O2 100 3
anaesthetic machine flowmeter. 21 20

5. Allow the oxygen to flow until the oxygen 5

monitor readout (4) stabilises.
4
6. Calibrate the sensor, using the AV-S ventilator
menu procedure, as follows.

7. Press the menu switch (5) and select the O2 6

monitor sub-menu.

8. Scroll to CALIBRATION.
If the menu shows 21% (which indicates
calibration using air), press the navigator
wheel / button (6) to switch to 100%
(calibration using oxygen).

9. A message will flash on the screen:

O2 AT 100% ?
Press the button (5) to confirm O2 Monitor & Spiro
NOTE
The message:
ESCAPE FROM MENU
OXYGEN SENSOR LOW OUTPUT
will appear on screen if the user attempts to O2 MONITOR: on
calibrate at 21% in 100% oxygen. > CALIBRATION: 100%
HIGH ALARM SET: 105
10. Scroll to ESCAPE FROM MENUS and press LOW ALARM SET: 18
the button (6) to exit. SPIROMETER: on
11. Turn off the flow of oxygen. SPIRO CALIBRATION: 0 L/min
12. Refit the absorbent canister (1).

52
PRE-OPERATION PROCEDURES - O2 Monitor

5.3.3 Sensor Low Indication

The unit automatically detects when sensor
life is low. O2 Monitor & Spiro
The message:
OXYGEN SENSOR LOW OUTPUT ESCAPE FROM MENU
will appear on screen to indicate that the O2 MONITOR: on
sensor must be replaced. CALIBRATION: 100%
The sensor output will fall very quickly to > HIGH ALARM SET: 105
zero over a period of two to three weeks LOW ALARM SET: 18
from the first time that the alarm is SPIROMETER: on
activated. SPIRO CALIBRATION: 0 L/min

Sensor replacement - see Appendix 4.

5.3.4 Setting the O2 Alarms

5.3.4.1 Set High Alarm

The high alarm value cannot be set below
19% or above 105% (Note that in certain High Alarm
conditions of excess pressure, the readout Set Value
may show a value above 100%.).
1. Touch the O2 concentration display, or
o IO
o . . On/Off Switch
Press the menu switch on the
ventilator front panel and select the O2 %O2 100
Alarm Mute
monitor sub-menu. 21 20
2. Scroll to HIGH ALARM SET and
press the navigator wheel. Menu Switch
3. Rotate the wheel to change the
displayed alarm figure to the desired
value. Low Alarm
Set Value
4. Press the wheel to confirm.
5. Scroll to ESCAPE FROM MENUS
and press the wheel to exit.
Navigator
Wheel and
5.3.4.2 Set Low Alarm Press Button
The low alarm value cannot be set lower
than 18%, or above 99%.
1. Touch the O2 concentration display, or
Press the menu switch on the
ventilator front panel and select the O2
monitor sub-menu.
2. Scroll to LOW ALARM SET and
press the navigator wheel.
3. Rotate the wheel to change the
displayed alarm figure to the desired
value.
4. Press the wheel to confirm.
5. Scroll to ESCAPE FROM MENUS
and press the wheel to exit.

53
6. SERVICE PROCEDURES

6.1 Service Intervals

At 6 months, 12 months, 2 years and 4

years, the ventilator must be serviced by a
Penlon-trained engineer, following the
schedule given below, and the procedures
given in section 7 in this Service Manual.

Every day:
Pre-use function check

Every week:
Check the condition of the diaphragm valve,
and clean as required.

Test the Mains Failure Alarm and the Low

Supply Pressure Alarm

Every 6 months:
Inspection and Function Check.
Remove patient block assembly and clean.
Check condition of bellows.

Every 12 months:
Repeat six month procedure, plus:
Replace components, including O-seals,
exhaust diaphragm, one way valve.
Preventive maintenance kit available.

Every 2 years:
Repeat 12 month service, plus:
Replace battery.

Every 4 years:
Repeat two-year service, plus:
Replace PCB battery and bellows
diaphragm valve.

Details of these service operations are given

in section 7 of this manual.

Always ensure that a record is kept of any

service or repair work.

54
SERVICE PROCEDURES

6.2 Control Unit Patient Block

Assembly - Removal

On a regular basis (in line with hospital

procedures for infection control), the
patient block (1) must be removed,
1
cleaned and sterilised (see Appendix 4).

1. Detach the hoses from the outlets 3

(2).
Note different diameters for correct
refitment.
3 2 2
2. Undo the securing knobs (3).
3. Carefully detach the assembly (1)
from the control unit.
Note that resistance will be felt until
the metal tubes (4) disengage.
4
4. Wash thoroughly, then sterilise, as
recommended in Appendix 4.
Do not disassemble.

Refitting
5. Position the patient block and push
fully into the control unit, ensuring
that the metal tubes (4) are engaged 4
in their unions.
6. Fit the securing knobs (3).
7. Function test the ventilator.

55
SERVICE PROCEDURES

6.3 Valve Calibration

1. Disconnect the hoses from the 'Drive Connector',

'Airway Pressure Connector' and 'Exhaust
Connector' on rear of ventilator.
Carry out an 'Ambient Pressure calibration'. This
will zero all pressure transducers.

2. Disconnect the fresh gas hose from the

anaesthesia machine Common Gas Outlet.
Switch the Bag/Vent switch to 'Bag' and remove
bag from bag arm.
Remove the patient circuit.
Carry out Spirometry Zero calibration. This will
zero the 'Drive Flow' transducer.

3. Using a safety bung, occlude the 'Drive Connector'

on rear of ventilator.
From 'Cal Valve' menu select 'ZeroDV'.
Wait for 'ZeroDV cal complete' message.

4. Remove the bung and connect the breathing

circuit as for normal use.
With Absorber in 'Vent' position, set the Fresh Gas
flow from anaesthesia machine to 5 L/min.
From 'Cal Valve' menu select 'ZeroPV'.
Wait for 'ZeroPV cal complete' message.
Reduce fresh gas flow to minimum.

5. Disconnect the hose from 'Drive Connector' and

connect a flow measurement device.
From 'Cal Valve' menu select 'DV Meas'.
Check that the measured value is the same as the
measurement device (approximately 20 Lmin).
If not, adjust using 'Trim Drive Flow' control.
After each adjustment press wheel to confirm
change and wait for displayed value to adjust and
settle back at 20 L/min.
Adjust again as necessary until the displayed
value is the same as the measured value.
Select 'None' to end calibration.

6. From 'Cal Valve' menu select 'DV Curve'.

The valve will oscillate several times then
generate an increasing flow delivery to its
maximum flow.

7. Valve calibration procedure is now completed.

56
7. SERVICE SCHEDULE

1 Initial Checks (every six months)

1.1 Check serial number to determine service required.

1.2 Check general condition of ventilator.

1.3 Check configuration of attachments, tubing, cables and connectors.

Note, or replace as necessary.

2 Power On and Display Checks (every 6 months)

2.1 Mains indicator illuminates amber when unit is switched off and connected to the
mains.

2.2 Turn ventilator on.

2.3 Check audible alarm activates

2.4 Default selection screen appears and automatically defaults to adult mode in 'Standby'
after approximately eight seconds.

2.5 Mains indicator illuminates green

2.6 Check screen is undamaged, display is clear and that the touch sensitive screen
functions are operating correctly.

2.7 Check operation of On-screen Indicator control using navigator wheel

3 Menu Selection Tests (every 6 months)

3.1 Press 'Menu' button and check menu screen appears.

3.2 Rotate Navigator wheel and check menu scrolls.

Check sub-menus can be selected by pressing the Navigator wheel.
Note: some menu selections will time out after approximately 8 seconds of inactivity.

3.3 Restore any changed settings during above tests.

4 Engineers Mode (Available in Standby only) (every 6 months)

4.1 Press Menu button and select 'Service Menu'

4.2 Select 'Clock Menu' check date and time are correct.
Year = 2005 - 2099
Month = 1-12 (Jan - Dec)
Date = 1- 31
Hour = 1-23
Minute = 1-59

4.3 Select 'Upgrade Menu' check software revisions

I/O Firmware for the main board
Main Firmware for CPU core
Select 'Ambient Pressure' check reading is correct (+/- 10 mbar).
Adjust as necessary by selecting 'Engineer Menu' - 'Penlon Options Menu' - 'Cal
Pressure'
Adjust to correct value.

57
SERVICE SCHEDULE

5 Engineer Error Codes (every six months)

5.1 Select 'Service Menu' - 'Engineer Menu' - 'Diagnosis Menu'- 'Display Error Log'

5.2 Check and investigate errors.

Up to 30 Error Codes can be stored.
Format is: Date - Time - Fault
Example: 08/05/01 - 09:12:40 - Cut Valve

5.3 Reset Error log.

6 Bellows Assembly (every six months)

6.1 Remove and clean canister.

6.2 Remove bellows from base and inspect bellows.

6.3 Discard old bellows and replace with new. (every 12 months)

6.4 Remove diaphragm valve (3 x thumbscrew)

6.5 Inspect valve seat for damage

6.6 Check valve disc hangs level.

6.7 Replace diaphragm valve (every four years)

If necessary clean valve seat and valve disc using alcohol wipe.
Do not attempt to dismantle diaphragm assembly.

6.8 Replace large orange O-ring on bellows base (every 12 months)

If AV-S is used with an A200SP Absorber, this O-ring is replaced as part of the absorber service
procedure
Replace small O-ring from diaphragm valve. (every 12 months)
Apply oxygen approved grease

6.9 Refit diaphragm valve and secure. (3 x thumb screws)

6.10 Refit bellows and canister.

6.11 With hand occlude the Inspiratory connector of the absorber.

Inflate bellows assembly using flush button until bellows is at top of housing.
With no flow from anaesthesia machine bellows should not drop.

6.12 Move hand from Inspiratory connector, and occlude drive gas hose at rear of absorber.
Bellows will fall momentarily but then should stop falling.

Note:
Failure of either 6.11 or 6.12 indicates a bellows leak, diaphragm valve leak, drive gas
hose leak or canister leak.

58
SERVICE SCHEDULE

7 Pneumatic System Tests (every six months)

7.1 With unit switched off, disconnect mains supply.
Unscrew thumbscrews at rear of unit and withdraw Patient Valve Block.

7.2 Remove Diaphragm valve, spring and spring cap.

Remove the Non-return Valve.
Clean and examine for damage or discolouration. Replace as necessary.
Refit the Non-return Valve.
With the spring, spring cap, and the diaphragm still removed, use a suitable bung to
occlude the spring orifice.
Use an inflation bulb to apply pressure to the drive gas connector.
Pressure should relieve at 100 cmH2O 10%

7.3 Replace diaphragm valve and non-return valve (every 12 months)

7.4 Replace 5 mm, 7mm, and 12 mm O-rings (probe) (every 12 months)

7.5 Reassemble the patient valve block.

7.6 Leak test gas inlet to unit On/Off -valve.

Ensure less than 7 kPa/min

7.7 With patient valve still removed, connect ventilator to power supply, reconnect gas
supply and switch on the unit.
In 'Standby Mode', set inspiratory flow of 5 L/min using front panel settings: 500, 5,
1:1, OFF, 38.
Switch ventilator to 'Volume Mode'

7.8 Connect test gauge to primary regulator test point and check regulator set to 262 kPa
21 kPa (38 psi +/- 3 psi) during inspiratory phase.
If adjustment is necessary, the cover must be removed.

7.9 Connect manometer to output of patient proportional valve (small probe) and check for
90 cmH2O +/- 10% during the inspiratory phase and zero during the expiratory phase.
Adjust secondary regulator as necessary

7.10 During expiratory phase ensure that there is no gas flow from the Drive Gas
connector.
If necessary carry out Drive Gas Valve Offset calibration.

8 Control Unit (every 6 months)

8.1 From 'Diagnosis Menu' check flow transducer zero offset levels.
Drive flow; Inspiratory Flow and Expiratory Flow should all read approximately 80
mV.

8.2 Check all electrical connections and components for security. (every 12 months)

8.3 Replace back up battery. (every 2 years)

NOTE: Check battery type (30 minutes back-up, or 1 hour back-up)

8.4 Replace Real Time battery. (every 4 years)

9 Set Up (every 6 months)

59
SERVICE SCHEDULE

9.1 Select drive hose O2 or Air.

Attach to the 'Driving Gas Input' connection to the rear panel.

9.2 Connect the long corrugated hose to the 'Drive Gas Output' connector of vent and the
vent drive gas connector at rear of absorber.

9.3 Connect the pressure tube to 'Patient Pressure' connection on the rear panel of the
control module to the Pressure Sensing port on the rear of the absorber.

9.4 Connect the cable from the 'Interface' connector on the rear panel of the control
module and to the 'Interface' connection on the rear of the absorber.
Connect the cable from the 'Prima Master' connector on the rear panel of the control
module and the rear of the Prima SP anaesthesia.

9.5 Attach the 'Fresh Gas Supply' hose from the absorber to the CGO of the PrimaSP

9.6 Connect a patient breathing circuit to the CO2 absorber and attach the patient
connector to a test lung.

9.7 Connect the Gas Scavenging System to the Exhaust' connector on the rear of the
vent. (If no scavenge system is attached to the rear of the ventilator, a continuous
bleed during the inspiratory phase will be audible)

10 Standby (every 6 months)

10.1 Power On the Anaesthesia machine. Ventilator should switch 'ON'

10.2 Power Off the Anaesthesia machine. Ventilator should switch 'OFF'

10.3 Press the Power button on the ventilator.

10.4 Default selection screen appears and automatically defaults to adult mode after
approximately eight seconds

10.5 Note: Standby mode is highlighted white in the bottom right of screen.

10.6 Set incorrect rate, i.e. increase Vt, and/or Rate controls.
Check 'Incorrect Rate Or Ratio' displayed on screen and three alarm tones sound.
Do not confirm settings; wait for default values to return.

11 Oxygen Analyser Function and Calibration Tests (every 6 months)

11.1 Connect a calibrated O2 Analyser into inspiratory connector.

11.2 Check Vent O2 sensor is inserted into the absorber O2 sampling point.

11.3 For A200SP absorber: remove absorbent canister.

For A100SP absorber: set absorber 'On/Off' switch to 'Off'.

11.4 Attach a short hose to Inspiratory limb.

Use O2 flush for 20 seconds then set a 5 L/min flow of oxygen and allow reading to
stabilise.
Ensure 100% indicated on test device and ventilator display is stable.

11.5 Calibrate Vent in 100% Oxygen.

11.6 From menu select 'Oxygen Monitor & Spirometry'-'Calibration'.

Adjust until 100% is indicated.
60
SERVICE SCHEDULE

Press navigator wheel to confirm.

11.7 Exit menu and set fresh gas flow to minimum

11.8 Expose both sensors to air and check reading is 21% +/- 2

11.9 On ventilator, adjust high and low O2 alarms.

Check alarms trigger when values are lower or higher than the reading on the
ventilator O2 display respectively.
Return alarm levels to original settings.

11.10 Restore ventilator O2 sensor to correct location.

Remove test O2 analyser.

12 Spirometer Calibration (every 6 months)

12.1 Check condition of external Spirometer cables and connections.

12.2 Disconnect fresh gas hose from anaesthesia machine Common Gas Outlet.
Switch the Bag/Vent switch to 'Bag' and remove bag from bag arm.
Remove test lung from patient connector if fitted or remove patient circuit.
Ensure scavenging circuit is not connected.

12.3 Check Spirometer is enabled in menu.

12.4 From menu select 'Oxygen Monitor & Spirometry' - 'Spiro Calibration'.

12.5 Rotate dial until '0 L/min' is displayed.

Press Navigator wheel to calibrate Spiro.
Display will flash 'Calibrating Zero'

12.6 If successful 'Calibration complete' will be displayed.

12.7 Connect short hose between CGO and absorber Expiratory connection.
Connect the absorber Fresh Gas connector to the Bag arm connector to ensure a
closed system.

12.8 Adjust oxygen flowmeter on anaesthetic machine to achieve accurate 10 L/min flow

12.9 Re-enter 'Oxygen Monitor & Spirometry' - 'Spiro Calibration' in menu system.

12.10 Rotate Navigator wheel until 'Calibrate 10 L/min' is displayed.

Press Navigator wheel to calibrate Spiro.
Display will flash 'Calibrating 10 litres'

12.11 If successful, 'Calibration complete' will be displayed.

12.12 Reconnect fresh gas hose, patient circuit and manual bag.
Reset bag/vent switch to 'Vent' position.

13 Spontaneous and Special Modes (every 6 months)

13.1 Switch absorber to 'Bag'
Select 'Spont Mode' on touchscreen.

61
SERVICE SCHEDULE

13.2 Operate Test Lung (by hand).

Check 'Vt meas.', 'BPM' and 'I:E' at bottom of display indicate readings.
Observe waveform displayed.

13.3 Stop operation of test lung.

Ensure pressure reading falls to zero and after 15 sec delay check 'Apnoea' alarm
triggered and 'Vt meas.' shows '= = ='.

13.4 Press 'Mute'.

Verify audible alarm is muted for 120 seconds.
(Note alarm mute countdown displayed at bottom right of touch screen.)

SIMV checks
13.5 Switch ventilator to 'Standby'
From the 'Special Modes' menu select SIMV.

13.6 Re-select 'Spont Mode'

Select 'SIMV' Message on screen will read 'Switch absorber to vent position'.
Change absorber position to 'Vent' Ventilator now displays 'SIMV' message in white.

13.7 Note: If absorber switch is not enabled in service menu, the message will read 'Switch
absorber to vent position'
Press 'SIMV' once again.

13.8 Operate Test Lung very gently (by hand)

Check that occasional ventilator assistance is given.

13.9 Stop operation of test lung.

Ensure test lung is ventilated at the default settings: 600ml; 6 bpm; 3.3 sec Ti

SMMV checks
13.10 Switch ventilator to 'Standby'
From the 'Special Modes' menu select SMMV.

13.11 Re-select 'Spont Mode'.

Select 'SMMV' The message on screen will read 'Switch absorber to vent position'.
Change absorber position to 'Vent'. Ventilator now displays 'SMMV' message in white.

13.12 Note: If absorber switch is not enabled in service menu, the message will read 'Switch
absorber to vent position'
Press 'SMMV' once again.

13.13 Operate Test Lung very gently (by hand).

Check that occasional ventilator assistance is given and that the measured Minute
Volume is 3.6 litres
Stop operation of test lung.
Ensure test lung is ventilated at the default settings: 3.6 litres; 6 bpm; 3.3 sec Ti

PSV checks

13.14 Switch ventilator to 'Standby'

From the 'Special Modes' menu select PSV.

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SERVICE SCHEDULE

13.15 Re-select 'Spont Mode'

Select 'PSV'
Message on screen will read 'Switch absorber to vent position'.
Change absorber position to 'Vent'
Ventilator now displays 'PSV' message in white.

13.16 Note: If absorber switch is not enabled in service menu, the message will read 'Switch
absorber to vent position'
Press 'PSV' once again.

13.17 Operate Test Lung (by hand) and check that ventilator assistance is given with a
pressure of 4 cmH2O.

13.18 Stop operation of test lung.

Ensure pressure reading falls to zero, and after 15 sec delay check that the 'Apnoea'
alarm is triggered, and that 'Vt meas.' shows '= = ='.

14 Volume Cycle & Flow Compensation Tests (every 6 months)

14.1 Switch Ventilator to 'Volume ' Mode

14.2 Set 'Vt' to 600 ml, 'BPM' to 10, 'I:E' to 1:2 and 'Pressure Limit' to 80.

14.3 From Menu, select Fresh Gas compensation OFF.

The bellows delivers 600 ml + 50 ml but the measured volume may be reduced to
approximately 500 ml with a standard test lung due to the compliance losses of the
circuit.
Note: If bellows delivery is out of specification, carry out valve calibrations (section 6.3)

14.4 Apply a flow of Oxygen from anaesthetic machine of 8 L/min.

Check displayed 'Vt Meas' rises.

14.5 From Menu select Fresh Gas compensation ON.

Allow 2 minutes for reading to stabilise.
Observe that the bellows delivers less gas than before.
Check displayed 'Vt Meas.' = 600ml +/- 50 ml.
Using a Wrights Respirometer check the expiratory volume is +/- 50 ml of the
displayed value.
Note: If Vt Meas is out of specification, repeat spirometery calibrations at zero and 10
l/min.

14.6 Press 'Insp Pause'

Check for 25% pause during the inspiratory phase.
Switch Off Inspiratory pause.

14.7 Reduce fresh gas flow to basal

14.8 Press 'Wave Freeze' and check waveform freezes.

Press again to clear.

14.9 Set PEEP to 10 cmH2O

Check waveform to see that it displays 10 cmH2O of PEEP. (Straight line is good.
Decline of line indicates leak.)
Turn off PEEP.

63
SERVICE SCHEDULE

14.10 Adjust Airway Pressure

Observe changing scale on waveform.
Reset to 38 cmH2O.

14.11 Touch waveform screen

Check that the following second waveforms are selectable and waveform is displayed.
1. Volume v Time.
2. Pressure v Volume (Compliance Loop).
Reset back to 'None'.

14.12 Check the ventilator is operating smoothly, and that the test lung is inflating.
Check that the absorber manometer indicates +/- 5 cmH2O of the system pressure
displayed on the ventilator screen.

15 Airway Alarm Tests (every 6 months)

15.1 Set ventilator to default settings and ventilate test lung in 'Volume' mode.

15.2 Disconnect test lung and occlude patient connector.

Ensure 'High Airway Pressure' alarm occurs and circuit pressure is limited to 38
cmH2O.
Reconnect test lung and ensure alarm clears.

15.3 Disconnect test lung and open patient connector.

Ensure 'Low Airway Pressure' alarm occurs.
Reconnect test lung, refill bellows and ensure alarm clears.

15.4 Volume cycle the ventilator, adjust Vt Set to achieve a peak airway pressure of greater
than 30 cmH2O of water.

15.5 At peak pressure, clamp the pressure sensing tube.

The displayed waveform should show pressure greater than 30 cmH2O continuously.
Check that 'High Continuous Pressure' alarm is activated.
Unclamp pressure-sensing tube and allow the ventilator to cycle.
Reset ventilator to default settings.

15.6 Disconnect mains power supply

Verify that the ventilator continues to operate on battery.
Check that the 'AC Power Fail' alarm is displayed.
Reconnect mains power supply to ventilator.

15.7 Remove drive gas line from gas supply outlet.

Check that the 'Low Supply Pressure' alarm activates.

15.8 Reconnect drive gas line and ensure alarm clears.

16 Pressure Ventilation (every 6 months)

16.1 Switch Ventilator to 'Pressure'.

The ventilator will automatically set 'Target Pressure' to 10 cmH2O.
Verify pressure is held at this setting.

64
SERVICE SCHEDULE

16.2 Carry out leak test.

Set 'Rate' to 5 BPM, I:E to 1:1, and 'Pressure Target' to 50 cmH2O
Ensure flowmeter on anaesthesia machine is set to minimum.
Fill bellows using O2 flush, allow bellows to cycle and verify bellows remain full.
If necessary adjust flow from anaesthesia machine to maintain full bellows.
Maximum permissible flow (leak): 200 ml.

16.3 Check waveform holds the airway pressure values. (Level display)
A falling display indicates a leak either in the driving circuit, the patient circuit or the
absorber system.

17 Electrical Safety Checks (every 6 months)

17.1 Earth Continuity (Max 0.2 ohms) at 1 Amp or less
17.2 Insulation Resistance (not less than 20 Meg Ohms) at 340-500 Vdc
17.3 Earth Leakage (Max 500 micro amps)
17.4 Enclosure Leakage (Max 100 micro amps)

18 Paperwork (every 6 months)

18.1 Restore user settings.

18.2 Sign and date service card, indicate service: 6, 12, 24 or 48 month.
18.3 Attach label: 'This Equipment Has Been Serviced in prominent position.
18.4 THINK, carry out visual checks. Remove all tools, and test equipment.
18.5 Fill out appropriate service report.

NOTE

This checklist is prepared for use by Penlon Service Engineers.

It is not a maintenance manual and should not be used as such.
Other parts may be replaced if signs of wear are apparent. If a replacement is necessary the
hospital must be informed.

65
8. PARTS LIST

Preventive Maintenance Kits Four year Kit:

Part No 57300 - with standard battery
One year Kit: Part No 57298 As Two-year kit 57299, plus:
Patient Block Assembly: 3v PCB battery 104019
Exhaust diaphragm 300580 Bellows diaphragm valve 406020
One-way valve 300581
O-ring 5 mm 041204 Four year Kit:
O-ring 7 mm 041245 Part No 57301 - with high-power battery
O-ring 12 mm 041222 As Two-year kit 57302, plus:
3v PCB battery 104019
Bellows Assembly: Bellows diaphragm valve 406020
O-ring 5 mm 041204
Bellows 57550
O-ring - bellows base 041226 Note
Fit this O-ring only if the AV-S is not used with an If a paediatric bellows assembly is used with the AV-
A200SP Absorber, S, the O-ring on the bellows adaptor must be
renewed annually.
Order O-ring, Part No 041225
Two year Kit:
Part No 57299 - with standard battery
As One-year kit, plus:
12v battery 103996
(30 minutes backup)

Two year Kit:

Part No 57302 - with high-power battery
As One-year kit, plus:
12v battery 5003058
(1 hour backup)
57550
Bellows

041226
041204
O-ring
O-ring
041204 041245 (See Note, above)
O-ring O-ring
IMPORTANT:
1. Discard clear plastic
041222 slotted spacer, if fitted
O-ring 2. Always reassemble
with solid, opaque
spacer.

300580
Diaphragm
300581
One way Valve

Patient Block

66
PARTS LIST

5000492
Arm Assembly

Control Unit and Remote Display Screen Assemblies

Item Part No. Description Quantity
1 01056 M5 x 12 SKT HD Cap Screw 4
2 300529 Screen Display Assembly (Remote) 1
3 5000543 Chassis Assembly (Remote) 1
4 01130 M5 X 16 SKT Cap Head Screw ST STL 4
5 300549 Interface Cable - screen to control unit 1
(not shown)
6 5000599 Interface Cable - A200 Absorber to control unit 1
(not shown)

67
PARTS LIST

Display Screen Assembly

Item Part No. Description Quantity

1* 300540 Front Moulding 1
2* 300541 Rear Cover 1
3 300575 Spinner 38 mm 1
4 300573 Gasket 2
5* 01253 M4 X 25 SKT HD Cap 4
6 300550 Membrane Switch + LEDs 1
7 019122 M3 X 6 LG Button HD 4
8 300516 LVDS Encoder Assembly 1
9 01013 M4 X 10 SKT HD Cap 4
10 300547 O Ring Cord 1
11 300524 TFT Sub Assembly 1
12 01059 M2.5 X 6 CH HD 2
13 025606 M3 Fibre Washer 6
14 15056 Product Label 1
15 15446 Warranty Label 1

68
PARTS LIST

Screen Assembly (300524)

Item Part No. Description Quantity

1 300565 8.4 TFT Screen (NEC) 1
2 300531 TFT Mounting Plate 1
3 300567 Inverter 5V 1
4 300599 M2.5 X 16 Butt HD SS 4
5 5000544 M2.5 Nyloc Nut ST STL 4
6 300536 Tape (Touch Screen To TFT) 1
7 300537 Tape (TFT To Plate) 1
8 300566 8.4 Touch Screen 1

69
PARTS LIST

Control Unit Assembly (5000453)

Item Part No. Description Quantity

1 01056 M5 x 12 SKT HD Cap Screw 4

2 300534 SP Mounting Plate 1
3 019171 M4 x 10 But Flanged HD 10
4 300564 Short Form Instructions 1

5 019049 M3 X 10 LG Pan HD 3
7 5000489 Chassis Assembly 1
8 5000499 Tray Assembly (Remote) 1

9 15446 Warranty Label 1

10 15056 Product Label 1
11 034072 M5 Cover Plug 4
12 5000460 Cover - AVS 1

70
PARTS LIST

71
PARTS LIST

Control Unit Chassis Assembly (5000489)

Item Part No. Description Quantity

1 5000459 Chassis - AVS 1

2 5000156 Regulator & Control Assembly 1
4 300595 DISS Con Nut 1
5 011240 Rubber Foot 4
6 01235 M8 Internal Star 1
7 01149 M8 Locknut 1

8 103996 Battery (30 minutes backup) 1

5003058 Battery ( 1 hour backup)
9 104715 LEC Mains Connector / Filter 1
10 2220-099 LEC Mains Plug Retainer Assembly 1

11 5000449 Patient Valve Block Assembly 1

12 35150 Hose - Hose Panel Connector 1
13 019122 M3 X 6 LG Button HD 4
14 5000505 External Circlip 10 mm Shaft 2

15 5000498 Power Supply Bracket 1

16 5000504 External Circlip 8 mm Shaft 2
17 5000472 Chassis Label - AVS 1
18 300569 Power Supply 1
19 300634 Straight Connector 5 O/D Tube - M5 1
20* 5000540 Bostik Silicone Sealant A/R

21 5000488 Pressure Connector 1

22 041204 5.1 I/D X 1.6 CS Viton 1
23 500506 Tray Gasket 1

24 5000487 Bleed Adaptor 1

26 054541 Tube Conn 1
27 041245 O Seal 7.0 X 1.5 1

29 300609 Sensor Assembly 1

30 019067 M4 X 12 SKT HD Cap 2
31 011241 D/S Tape 3Ms X 105 mm Long 2
32 019087 M3 X 16 Cap HD Screw 2
33* 057002 Loctite 222 A/R
34 011169 M4 Skiffy Cap 2
36 019121 M4 X 8 Button HD 1
37* 300638 Tube 4.0 O/D A/R
38* 300637 Tube 5.0 O/D A/R
39* 011092 Silicon Tube O/D 6 mm X I/D 3 mm A/R
40 104038 Fuse, 2 Amp T HRC - 20 mm, UL 2

72
73
PARTS LIST

74
PARTS LIST

Regulator Assembly and Control Block Assembly

Item Part No. Description Quantity

1 300526 Regulator Assembly 1

2 5000482 Control Block Assembly 1
3 019037 M3 X 35 Cap HD 4
4 041221 O Ring 8.1 X 1.6 1

75
PARTS LIST

Patient Block Assembly

Item Part No. Description Quantity

1 300580 Diaphragm 1
2 300581 One-way valve 1
3 300583 Inline Relief Valve 1
4 5000478 Check Valve Cap 1
5 300593 Taper Adaptor 1
6 300594 Tapered Conn 1
7 5000448 Spring Guide 1
8 5000450 Valve Body 1
9 5000451 Seat Insert 1
10 5000452 Drive Gas Block 1
11 5000453 Valve Base 1

12 0501 O Ring 1
13 01014 M4 X 16 SKT HD Cap Screw Ss 4
14 011169 M4 Skiffy Cap 4
15 019028 M3 X 6 Grub Ss Cup 1
16 019087 M3 X 16 Cap HD Screw 4
17 019128 M4 X 8 Butt HD CHEM BLK 4
18 019153 M4 X 50 Cap Head SS 4

19 041214 O Ring RM 0221-16 Viton 1

20 041217 O Ring 1
21 041250 O Ring 27.6 X 2.4 1

22 300561 Compression Spring 1

23 5000444 M4 Tappex Trisert 8
24 5000445 M3 Tappex Trisert 4
25 5000475 Mounting Plate 1
26 5000476 Mounting Plate Label 1

76
PARTS LIST

77
9. APPENDIX

APPENDIX 1
Care of Back-up Battery
CAUTION
Damage may occur if the battery is allowed to remain in a discharged
state.
Never discharge the battery to below 10.2 volts.

A. Battery installed in ventilator

The battery must be charged before the machine is released for use
with an 14 hour charge from the ventilators internal power supply
(ventilator connected to the mains supply, but not running).
Note that the mains power indicator on the front panel will show a
yellow light during charging.
Subsequently the recharge periods for a battery on a ventilator in
store are similar to those in B, below.
Batteries in machines in normal use will be kept charged by the
internal power supply.
Note that the Low Battery Alarm indicator may be displayed if
automatic recharging is taking place as the ventilator is in use.

B. Battery care/storage requirements.

During storage, batteries will require a periodic recharge, the
frequency of which is determined by the storage temperature,
which must not exceed 50oC (120oF).

Storage Recharge
temperature period

38 to 50oC (100 to 122oF) 1 month

21 to 38oC (70 to 100oF) 3 months

7 to 21oF (45 to 70oF) 6 months

0 to 7oC (32 to 45oF) 9 months

-5 to 0oC (23 to 32oF) 12 months

Duration - recharge for a minimum of 12 hours (typically overnight).

It is recommended that at each charge an updated label is affixed
to the unit to indicate date of the last charge.

C. Disposal of used batteries

Follow all hospital, local, state and federal regulations.

Note
Removal/replacement of battery must only be undertaken by a trained
technician

78
APPENDIX 2

APPENDIX 2
On-screen Menus
NOTE:

1. All selection or changes in the menu are

followed by a "CONFIRM" message
prompt on the screen, and accompanied
by a "BEEP" (user volume set)

2. The selected text or option will invert in

colour

3. User settings menus only activate in

Standby mode.

4. Clock menu, Upgrade menu, Diagnostic

menu only activate in Standby mode.

5. Special Modes on-screen tab only

activates in Spontaneous mode

6. Adult default settings

VT=600 mL
RATE=10 bpm
IE RATIO=1:2
Plimit=38 cmH2O
Ptarget=10 cmH2O

7. Paediatric default settings

VT=150 ml
RATE=15 BPM
IE RATIO=1:2
Plimit=38 cmH2O
Ptarget=10 cmH2O

79
Menu Structure
O2 Monitor & Spirometry

ESCAPE FROM MENU

O2 MONITOR: on off / on (Toggle option
CALIBRATION: 100% 21 / 100% (Toggle option)
HIGH ALARM SET: 105 19 -105 (Integer)
LOW ALARM SET: 18 18 - 99 (Integer)
SPIROMETER: on off / on (Toggle option)
SPIRO CALIBRATION: 0 L/min 0 L/min / 10 L/min (Toggle option)

Fresh Gas Compensation

Main Menu
ON / OFF off/on (Toggle option)
EXIT MENUS
O2 MONITOR & SPIROMETRY
FRESH GAS COMPENSATION: ON Support Mode pick list
SPECIAL MODES Special Modes none
WAVEFORM pressure
ALARM SETTINGS ESCAPE FROM MENU simv
GAS MIXTURE: O2+AIR SUPPORT MODE: none smmv
TRIGGER: 5 L/min Trigger pick list
USER SETTINGS 0.7 L/min
SIGH TO BREATH RATIO: 1:50
SERVICE MENU 0.7 L/min
Sigh to Breath 0.7 L/min
Ratio pick list 0.5 L/min
1:50 1.0 L/min
2:50 1.5 L/min
3:50 2.0 L/min
4:50 2.5 L/min
3.0 L/min
4.0 L/min

Waveform

ESCAPE FROM MENU

SECOND WAVEFORM: off Second waveform pick list
off
vol. vs time
vol. vs press.

Alarm settings

ALARM MENU
ESCAPE FROM MENU
ALARM MODE : default default / user (Toggle option)
HIGH TIDAL VOLUME: off off / on (Toggle option)
VM MIN: 0.3 L 0.0 - 7.4 (Integer)
VM MAX: 0.9 L 0.1 - 7.5 (Integer)
VT MIN: 300 mL 10 - 1600 (Integer)
VT MAX: 900 mL 20 - 2400 (Integer)
APNOEA ALARM LIMIT: 0.3 cmH2O 0.3 - 3.5 (Integer)
ALARM VOLUME: 50% 50 - 100% (Integer)

Gas mixture: O2+Air

O2+AIR
O2+N2O
O2+Xe
O2+He

Select settings
User Settings ESCAPE FROM MENU
USER1: CCT1
ESCAPE FROM MENU USER2: CCT2
SELECT SETTINGS USER3: CCT3
SAVE SETTINGS USER4: CCT4
BACK LIGHT LEVEL: 50% USER5: CCT5
VOLUME TYPE: tidal ADULT DEFAULT
PAEDIATRIC DEFAULT

Save settings
ESCAPE FROM MENU
USER1: CCT1 CONFIRM: CCT1
USER2: CCT2 CONFIRM: CCT2
USER3: CCT3 CONFIRM: CCT3
USER4: CCT4 CONFIRM: CCT4
USER5: CCT5 CONFIRM: CCT5

Backlight level
0 - 100% (integer)

Volume type
tidal/minute (toggle)
Service
See next page

80
Service
ESCAPE FROM MENU
LANGUAGE: ENGLISH Language pick list
PRINT PATIENT DATA ENGLISH
SERIAL MODE: none ITALIANO
CLOCK MENU TURKCE
UPGRADE MENU POLSKI
AMBIENT PRESSURE: 988 mBar ESPANOL
DISPLAY HISTORY
*SERVICE PIN: 0 Serial mode pick list
*ENGINEER MENU NONE
Philips
SPACELABS

Clock
ESCAPE FROM MENU Clock pick list (integer)
YEAR: 2005 2005 - 2099 (integer)
MONTH: 3 1 - 12 (integer)
DATE: 16 1 -31 (integer)
DOW: 3 1 - 7 (1 = Monday) (integer)
HOUR: 9 0 - 23 (integer)
MINUTE: 57 0 - 59 (integer)
UPDATE CLOCK
DAYLIGHT SAVING: off off / on (toggle option)

Upgrade
ESCAPE FROM MENU
I/O HARDWARE: 2
I/O FIRMWARE: v0.47 [Build 68]
MAIN FIRMWARE: v0.92 [Build 32]
REGISTRATION KEY: unknown
UPGRADE FIRMWARE: unavailable
ADD NEW FEATURE: unavailable

History Display
ESCAPE FROM MENU
MANUFACTURER DATE : 03/03/05
TOTAL HOURS RUN: 100
LAST SERVICE DATE: 13/08/04
HOURS SINCE SERVICE : 100
DRIVE VALVE CYCLES: 1253
PATIENT VALVE CYCLES: 822
CUTOFF VALVE CYCLES: 72

*NOTE
Service PIN
Engineer Menu

Sub-menus are not accessible by users.

81
APPENDIX 3
APPENDIX 3
AV-S Ventilator Spirometry System
Ventilator Spirometry Measurement
The AV-S ventilator drive gas and
spirometry system uses a total of three
mass flow gas sensors to monitor and then
independently measure the gas flows within
the ventilator and breathing system.
This ensures that correct volumes are
delivered to the patient.
These monitors are measuring firstly in the
ventilator delivery control system, and
secondly in the patient breathing system.
During use of the ventilator the user will set
a required tidal volume and at the first
breath the ventilator will use its pre-
calibrated delivery flow rate valve settings
to set the proportional delivery valve
position to deliver the requested tidal
volume.
To confirm that the correct flow rate (tidal
volume) is being delivered by the ventilator
delivery system an internal flow sensor (a
Honeywell AWM43300V mass flow sensor),
monitors the delivered flow rate and makes
adjustments every 30 ms using proportional
regulation.
As this sensor is always measuring the
known drive gas rather than breathing
system gas the volumes measured will
always be independent of breathing system
gas composition. This system ensures
accurate delivery volume from the ventilator
control unit.
To monitor for correct delivery volumes in
the breathing system there are two
breathing system mass flow sensors
(Honeywell AWM 720P1 spirometers).
One sensor is located in the inspiratory
limb, and one in the expiratory limb.
Measurements are taken from these
sensors to determine the actual delivered
and exhaled gas volumes in the breathing
system. This enable measurements to be
made to compensate for fresh gas flow,
compliance losses and possible breathing
system leaks.
During the inspiratory cycle the inspiratory
flow sensor measures the gas volume
delivered to the patient.
82
The flow sensor output is read at least
every 2 msec and then five sets of readings
are averaged and the averaged value is
sent every 10 ms to the processor for
calculation of the volume delivered to the
patient.
This delivered volume will consist of the
volume delivered from the ventilator bellows
plus the fresh gas flow from the anaesthetic
machine fresh gas supply, minus any
compliance loss and minus any leak.
This gives a total actual inspired tidal
volume.
A similar measurement method is used for
the exhaled volume. During the exhalation
period the measured exhaled volume is
subtracted from the inspired volume, and at
the end of exhalation.
A negative (more gas coming out) volume
indicates that fresh gas has increased the
delivered volume.
A positive volume (less gas coming out)
indicates a leak in the circuit.
The ventilator control system will then
adjust the next delivered tidal volume, up to
a maximum of 100 ml. This will bring the
delivered volume to exactly as set.
If the variation between set and delivered is
greater than the maximum rate of change
allowed, the adjustment will occur gradually
over several breaths.
The displayed volume is the average of the
inspiratory and expiratory volumes. If this
value is less or more than 50% of set
volume, a low or high volume alarm is
given.
Breathing System Gas Composition
Gas flow measurements are affected by the
breathing system gas composition. To
compensate for these effects the ventilator
has
a) a gas composition setting whereby the
user is able to select the gasses being
delivered, i.e. oxygen/air, oxygen/nitrous
oxide etc,
b) an oxygen monitor;
Thus the ventilator knows the overall
oxygen concentration and the majority of
the remaining gas composition.
 APPENDIX
Altitude Effects
Gas flow measurements are also affected
by atmospheric pressure, in a linear
relationship.
To compensate for altitude effects an
ambient pressure sensor is available. When
the spirometers are calibrated for zero flow
the ambient pressure is recorded so that
the measured volume may be adjusted.
The measured volume is multiplied by the
ratio of Pamb to Pcal; where Pamb is the
latest ambient pressure and Pcal is the
ambient pressure recorded when the
spirometers were calibrated at zero flow.
Carrier Gas Effects
The effect of air as the dilutent gas is
different to that of nitrous oxide and as the
ventilator includes only an oxygen monitor,
the additional information of gas being
ventilated is included to increase available
accuracy.
Anaesthetic Agent Effects
The addition of anaesthetic agent is known
also to increase the spirometry readings
depending on the agent and its
concentration by up to approximately 2%.
Again this minor volume measurement
variation is of no known clinical
disadvantage and is therefore not
compensated for other than that due to
oxygen variation due to the percentage
change.
Water Vapour Effects
Water vapour volumes in the breathing gas
are not detectable in normal breathing
system dynamics.
Additional Features
Additional spirometry features available for
selection by the user are the ability to turn
off the automatic compliance and fresh gas
compensation and also the feedback
provided by the oxygen monitor.
In this event, the ventilator relies on the
basic delivery look up table and the internal
flow sensor to confirm delivery volumes as
near as possible, under the circumstances.
Accuracies for spirometry measurement are
>300 ml 20%
>100 ml <300 ml 20%
<100 ml 50%.
83
Flow sensor description
The microbridge mass airflow sensor
operates on the theory of heat transfer.
Mass airflow is directed across the surface
of the sensing elements.
Output voltage varies in proportion to the
mass air or other gas flow through the inlet
and outlet ports of the package.
The specially designed housing precisely
directs and controls the airflow across the
microstructure sense element.
The microbridge mass airflow sensor has a
unique silicon chip based on advanced
microstructure technology. It consists of a
thin-film, thermally isolated bridge structure
containing heater and temperature sensing
elements. The bridge structure provides a
sensitive and fast response to the flow of
air or other gas over the chip.
Dual sensing elements positioned on both
sides of a central heating element indicate
flow direction as well as flow rate.
Laser trimmed thick film and thin film
resistors provide consistent
interchangeability from one device to the
next.
The microbridge mass airflow sensor uses
temperature-sensitive resistors deposited
within a thin film of silicon nitride. They are
suspended in the form of two +bridges over
an etched cavity in the silicon.
The chip is located in a precisely
dimensioned airflow channel to provide a
repeatable flow response.
Highly effective thermal isolation for the
heater and sensing resistors is attained by
etching the cavity space beneath the flow
sensor bridges. The small size and thermal
isolation of the microbridge mass airflow
sensor are responsible for the extremely
fast response and high sensitivity to flows.
Dual Wheatstone bridges control airflow
measurement - one provides closed loop
heater control, the other contains the dual
sensing elements.
 APPENDIX

The heater circuit minimizes shift due to

ambient temperature changes by providing
an output proportional to mass flow. The
circuit keeps the heater temperature at a
constant differential (160C) above ambient
air temperature which is sensed by a heat-
sunk resistor on the chip.
The ratiometric voltage output of the device
corresponds to the differential voltage
across the Wheatstone bridge circuit.

Sensor flow characteristics

The graph shown below is a typical flow
versus resistance graph for the Honeywell
spirometer head units for the flow range
showing typical hysteresis between up and
down flow measurements (and
repeatability).

5
4.5
4
3.5
Resistance 3
(cmH2O) 2.5
2
1.5
1
0.5
0
0 20 40 60 80 100 120 140

Flow
(L/min)

84
APPENDIX 4

APPENDIX 4
Cleaning A
Outside surfaces and bellows housing

CAUTION
Care must be taken not to allow liquids to run into the control
unit; serious damage may result.

Check that the unit is disconnected from the electrical supply

before cleaning.

Do not use cleaning solutions containing alcohol; the bellows

housing may be damaged.
B
To clean the outside surface of the ventilator, use a damp
cloth.
If necessary use a warm, mild detergent solution to
remove resistant grime. Make sure that all detergent
F
residues are fully removed after cleaning.

Never use any harsh abrasive cleaning agent. The

transparent acrylic bellows housing and, in general, the
surfaces of the control unit are not scratch resistant.

The inside of the bellows housing, under normal

conditions, is not in contact with the breathing gas and
therefore only needs cleaning as described above.

Remove the bellows housing (A) by slightly twisting it

counter-clockwise until the tabs at the bottom clear the Paediatric
bayonet locks, then lift it straight up from the base.
Bellows
Assembly
Touchscreen
Use a soft cloth only.
Never use any harsh abrasive cleaning agent.

Bellows and exhalation diaphragm valve

Each time the bellows assemblies are opened for C
cleaning, all visible components must be carefully
inspected and damaged parts must be replaced.

Bellows
As with all elastomers, the bellows material deteriorates
with aging and should be inspected at least every six
months or after 1200 hours of use, whichever comes first.
The bellows must be replaced if it shows signs of aging.

The bellows (B) can be removed by carefully pulling it off

the base.
If a paediatric bellows is fitted, the bellows adaptor (C)
must also be removed.

Do not dismantle the bellows.

85
APPENDIX 4

Exhalation Diaphragm Valve

The exhalation diaphragm valve is under the bellows
and can be removed by loosening the three E
thumbscrews.
The valve seat is now visible.
WARNING
Great care must be taken. Do not damage the precision
surface of the valve seat (D). D
Never use any hard object or abrasive agent to clean it;
use only a soft cloth.
If the valve seat is damaged, the diaphragm valve will
leak and may cause serious malfunction. Exhalation Diaphragm Valve
Assembly
Clean the seat, and the metal disk (E) attached to the
base of the diaphragm valve, thoroughly and remove
all contamination from the surfaces of both
components.

NOTE
If excessive contamination is discovered, check that a
bacterial filter is used in the expiratory limb of the breathing
circuit (or an HME at the patient tee-piece).

After cleaning, check that the small O-ring (F) located

in the bellows base under the diaphragm valve is in
place. The ventilator will not function if the O-ring is
missing.

See next page for information on sterilisation

procedures.

Refitting
Refit the diaphragm valve assembly to the bellows
base and reassemble the bellows assembly
If a paediatric bellows is fitted, press the adaptor (C)
into the ventilator bellows assembly base, then fit the
bellows.

CAUTION
Always check for correct fitment of the bellows (see
illustration), and function test the ventilator before clinical
use.

Spirometer Sensors
The sensors are built into the A200SP absorber, and
cleaning and sterilisation can only be carried out when
the absorber assembly is removed for cleaning.
For further information please refer to the user
instructions supplied with the A200SP.

86
APPENDIX 4

Sterilisation

CAUTION
To prevent possible damage to components, peak sterilisation temperatures must
not exceed 134oC (275oF) for steam autoclave.

Do not sterilise the ventilator control unit. Apart from the patient block assembly the
internal components are not compatible with sterilisation techniques and may be
damaged.

Recommended Sterilisation Parameters

Control Unit Patient Block Assembly

1. Clean, as described in section 6.2.5.3
2. Autoclave at 134oC, for a holding time of 3.5 minutes, using packaging and
equipment as listed below:

Packaging
Pack the control unit with material which is permeable to air and steam but has an
effective maximum pore size which is small enough to exclude microbial
contamination.
All wrapping materials must comply with EN 868: Packaging Materials for
Sterilization of Wrapped Goods.

Processing Equipment
The sterilizer must comply with the stated performance class BS 3970 and HTM
2010 and with additional requirements stated in Section D.
If a Porous-load sterilizer is used it must conform to the specifications in EN 285
and the safety specifications in EN 61010: Part 2-041.
Sterilization must be achieved by direct contact with good quality saturated steam .

Post-processing
Following reprocessing the patient block must be kept in a sterile plastic pouch to
avoid being re-contaminated prior to being fitted to the ventilator.

Refit in accordance with section 6.2.5.5. Function test the ventilator before clinical
use - see section 5.2.1.

Bellows Assembly Components

Item Method

Bellows Gas, liquid, autoclave (20 cycles maximum)

Hoses Gas, liquid, autoclave
O rings Gas, liquid, autoclave
Bellows base Gas, liquid, autoclave
Exhalation valve Gas, liquid, pasteurise, low temperature autoclave
assembly

Bellows canister Liquid, autoclave

87
APPENDIX 4

Oxygen Monitor Sensor

Cleaning / Disinfection / Sterilisation

In case of contamination the sensor (1) may be cleaned
with distilled water and allowed to dry naturally.
CAUTION
The sensor is not suitable for sterilisation by steam or
exposure to chemicals such as ethylene oxide or hydrogen
peroxide.
Do not immerse the sensor in any cleaning solution.
Do not autoclave or expose the sensor to high temperatures.

Bacterial Filter
Use a breathing system bacterial filter in the expiratory
limb of the breathing circuit to protect the oxygen sensor
(see section 5.1.8).
CAUTION
Replacement/Disposal - always follow the instructions
supplied with the filter, and always replace at the
recommended interval.

Oxygen Sensor Replacement

WARNING
The sensor contains:
A) A small quantity of electrolyte, classified as a harmful
irritant which is potentially hazardous.
B) Lead
Do not attempt to open a cell.
ALWAYS check the integrity of the sensor assembly
before use.
Once exhausted, the sensor must be disposed of
according to hospital, local, state and federal regulations.

Remove and Refit

Replacement parts: 102714 Sensor

1. Detach the cable connector (2) from the sensor (1).

2. Unscrew the sensor from the A200SP Absorber, and

discard.

3. Discard the expired sensor.

4. Screw the new sensor (1) into the absorber. 1 2

5. Attach the cable connector (2).

6. Fit the assembly into the absorber.

7. Calibrate the new sensor see Appendix 6. (check

software version)

8. Dispose of the used components according to hospital,

local, state and federal regulations.

88
APPENDIX 5

APPENDIX 5
Software Upgrade Installation
Procedure
2
Automatic Software Upgrade
Installation

The AV-S software is designed to be

automatically upgraded when connected to
an auto-upgrade disc with a USB floppy
drive (1) connected into the ventilator USB
port (2).

IMPORTANT NOTES:
1. The ventilator must be connected
only to a USB floppy disk drive, as
illustrated.
Use an industry-standard drive for
this application, to avoid data
transfer errors
2. It is not necessary to remove the
cover from the ventilator for the
software to be upgraded
automatically.
3. Do not install the upgrade from a PC,
or USB Memory Stick device 1

Automatic Software Upgrade.

1. Connect the AV-S to a mains power
source, but do not power the ventilator
on.
2. Connect a floppy disk drive to the USB
port on the rear of the ventilator.
Ensure the upgrade installation disk is
inserted in the drive.
6. Check on the AV-S start-up screen that
3. Switch the AV-S on.
the software version matches the
After a self-testing sequence, the floppy
installation disk.
disk drive should power up and display
on screen the upgrade status, followed 7. Carry out the valve calibration
by the success or failure of upgrade. procedure detailed in section 6.3.
4. When instructed, switch off the
ventilator by pressing and holding the 8. Read the notes on the datasheet
on/off button for about six seconds. issued with the upgrade.

5. Disconnect the the floppy disk drive 9. Ensure that any User Datasheet that
cable from the ventilator USB accompanies the upgrade is read and
connector (2) and switch the ventilator understood by the clinicians that will
on. use the ventilator.

89
APPENDIX 6

Calibration and Output Checks for a New Ventilator

Applicable to Software version: v1.81.11

On-Screen Menus
Menu Switch
To Access: Press the menu switch on the front panel

EXIT MENUS
O2 MONITOR & SPIROMETRY Navigator Wheel and
FRESH GAS COMPENSATION: ON Press Button
SPECIAL MODES
WAVEFORM Turn the wheel to scroll
ALARM SETTINGS through the menus.
GAS MIXTURE: O2+AIR Press the wheel to enter the
USER SETTINGS required sub-menu.
SERVICE MENU Rotate the wheel to change
the value of displayed
To Exit: parameters.
Press the menu switch on the front panel, or, select EXIT Press the wheel to confirm
MENUS and press the navigator wheel. the required value.

Before clinical use for the first time, the

following Valve Calibration, Spirometry
Calibration, and Volume Delivery Checks
must be carried out:

Drive Valve and Patient Valve Calibration

1. Disconnect the hoses from the Driving Gas

Output (A), Patient Pressure Connector
(B) and Exhaust outlet (C) on the rear of
the ventilator. Main menu
Calibrate the pressure transducers: EXIT MENUS
O2 MONITOR & SPIROMETRY
Press the menu switch FRESH GAS COMPENSATION: ON
SPECIAL MODES
Scroll down, select SERVICE MENU A WAVEFORM
Scroll down, select SERVICE PIN C B ALARM SETTINGS
GAS MIXTURE: O2+AIR
Enter PIN: 123 USER SETTINGS
Select ENGINEER MENU SERVICE MENU

Select PENLON OPTIONS MENU

Select CAL PRESSURE Service menu
This will zero all pressure transducers. ESCAPE FROM MENU
LANGUAGE: ENGLISH
Check that the Barometric Pressure PRINT PATIENT DATA
SERIAL MODE: none
reading is correct, if necessary adjust, and E CLOCK MENU
confirm. UPGRADE MENU
AMBIENT PRESSURE: 988 mBar
DISPLAY HISTORY
2. Disconnect the fresh gas hose from the SERVICE PIN: 0
Common Gas Outlet. D ENGINEER MENU
Switch the Bag/Vent switch (D) to Bag and
remove the bag from the arm (E).
Remove the patient circuit.

90
APPENDIX 6

Calibrate the drive gas flow transducer:

O2 Monitor & Spirometry menu
Select O2 MONITOR& SPIROMETRY
Select CAL. SPIRO ESCAPE FROM MENU
If menu shows calibration at 10 L/min, O2 MONITOR: on
CALIBRATION: 100%
rotate the wheel to set at 0 L/min
HIGH ALARM SET: 105
Press to confirm, note that display will LOW ALARM SET: 18
flash a message SPIROMETER: on
This will zero the Drive Flow Transducer. > SPIRO CALIBRATION: 0 L/min

3. Use a safety bung to occlude the Driving Gas

Output (A).
Select ENGINEER MENU
Select CAL VALVE MENU
Select VALVE CAL TYPE
Select: zero dv
Wait for display message: zero dv cal complete

4. Remove the bung.

Reconnect hoses to Driving Gas Output (A) and
Patient Pressure Connector (B).
Reconnect the fresh gas hose to the Common Gas
Outlet.
Connect the breathing circuit and test lung.
A
Select Vent on absorber Bag/Vent switch.
B
Set a fresh gas flow of 5 L/min.
Wait for the bellows to fully inflate.
Select ENGINEER MENU
Select CAL VALVE MENU
Select VALVE CAL TYPE
Select: zero pv
Wait for display message: Patient valve calibrated
Reduce gas flow to minimum.

5. Disconnect the drive gas hose from the rear of the

absorber (F).
Connect a flow measurement device.
Select ENGINEER MENU
Select CAL VALVE MENU
Select VALVE CAL TYPE
F
Select: dv meas
Check measured value is approximately 20 L/min.
If not, adjust using Trim Valve Flow on Menu.
After each trim valve flow adjustment press the
navigator wheel to confirm change. Wait for the
displayed value to adjust and settle to 20 L/min.
Select none from Menu to end calibration.
Remove the flow measurement device, but leave
the hose disconnected.

91
APPENDIX 6

6. Select ENGINEER MENU

Select CAL VALVE MENU
Select VALVE CAL TYPE
Select: dv curve
Observe valve oscillation and increasing flow
delivery up to maximum flow.
7. Valve calibration is now complete.

Spirometer Calibration
1. Check the condition of the external E
Spirometer cables and connections.

2. Disconnect the fresh gas hose from the

anaesthesia machine Common Gas Outlet. D
Switch the Bag/Vent (D) switch to 'Bag'.
Remove the bag from bag arm (E).
Remove the test lung from the patient
connector if fitted (or remove patient circuit).
Ensure the gas scavenging circuit is not
connected. O2 Monitor & Spirometry menu

3. Check Spirometer is enabled in menu. ESCAPE FROM MENU

O2 MONITOR: on
4. From main menu select O2 MONITOR & CALIBRATION: 100%
HIGH ALARM SET: 105
SPIROMETRY.
LOW ALARM SET: 18
Select SPIRO CALIBRATION SPIROMETER: on
> SPIRO CALIBRATION: 0 L/min
5. Rotate the navigator wheel until '0 L/min' is
displayed.
Press Navigator wheel to confirm setting.
This will calibrate the spirometry system.
The display will flash 'Calibrating Zero'.

6. If successful, 'Calibration complete' will be

displayed.
H
7. Connect a short hose between the CGO and
the absorber Expiratory connection (G).
Connect the absorber Fresh Gas connector
to the Bag arm connector (H) to ensure a
closed system.
G
8. Connect a short hose from the Inspiratory J
connector (J) open to atmosphere. This will
reduce vale oscillation.
Adjust oxygen flowmeter on anaesthetic
machine to achieve an accurate 10 L/min
flow

9. Re-enter O2 MONITOR & SPIROMETRY

Select SPIRO CALIBRATION.

92
APPENDIX 6

10. Rotate Navigator wheel until 'Calibrate 10 L/min'

is displayed.
Press Navigator wheel to confirm.
Display will flash 'Calibrating 10 litres'

11. If successful, 'Calibration complete' will be

displayed.

12. Reconnect fresh gas hose, patient circuit and

manual bag.
Reset the Bag/Vent switch to 'Vent' position.

Volume Cycle and Flow Compensation Tests

1. Switch Ventilator to 'Volume ' Mode

2. Set 'Vt' to 600 ml, 'BPM' to 10, 'I:E' to 1:2, and

'Pressure Limit' to 80.
Set the flow on the anaesthetic machine to
basal flow.

3. From the main menu select FRESH GAS Main menu

COMPENSATION: OFF. EXIT MENUS
O2 MONITOR & SPIROMETRY
The bellows delivers 600 ml + 50 ml, but the FRESH GAS COMPENSATION: ON
measured volume may be reduced to as low as SPECIAL MODES
WAVEFORM
500 ml with a standard test lung, due to the ALARM SETTINGS
compliance losses of the circuit. GAS MIXTURE: O2+AIR
USER SETTINGS
4. Note: If bellows delivery is out of specification SERVICE MENU
repeat the Valve Calibration procedure.

5. Apply a flow of 8 L/min Oxygen from the

Anaesthetic Machine.
Check that the displayed 'Vt Meas' value rises.

6. From menu select FRESH GAS

COMPENSATION: ON.
Allow 2 minutes for the reading to stabilise.
Observe that the bellows delivers less gas than
before. Check displayed 'Vt Meas.' = 600 ml +/-
50 ml.
Using a Wrights Respirometer, check the
expiratory volume value is within + 50 ml of the
displayed value.
7. Note: If Vt Meas is out of specification, repeat
zero spirometry calibration, and 10 l/min
spirometry calibration (it may be necessary to
set a flow slightly above or below the 10 l/min
graduation on the flowmeter, due to tolerance
mismatch between the flow sensor and the flow
tube).

93
APPENDIX 6

Main Menu Amendments : v1.86.01 / .02 / .04

On-screen Menu Structure

Additional sub-menu: Leak Test

Main Menu
EXIT MENUS
O2 MONITOR & SPIROMETRY
LEAK TEST MENU Leak Test
FRESH GAS COMPENSATION: ON
SPECIAL MODES
WAVEFORM
ALARM SETTINGS
ESCAPE FROM MENU
GAS MIXTURE: O2+AIR <START/STOP LEAK TEST>
USER SETTINGS
SERVICE MENU LEAK STATUS: unknown
LEAK LEVEL: 0 mL/min
BSYS COMP 7.0 mL/cmH2O

94
Cat No 52968
Doc No AV-S 0208 SM
June 2008

Manufactured by:
Penlon Limited
Abingdon Science Park
Barton Lane
Abingdon
OX14 3PH
UK

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Tel: 44 (0) 1235 547076
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E-mail: technicalsupport@penlon.co.uk

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